Li Hui, Jia Xuan, Ye Hui, Liang Jia-Wei, Zhao Wen-Li, Cui Ping, Sun Yaqi, Lai Deng-Ming, Shu Qiang, Jin Yue, Xie Guo-Hao, Fang Xiang-Ming
Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Wenyixi Road 1367, Hangzhou, 311121, China.
Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310003, China.
World J Pediatr. 2025 Apr 29. doi: 10.1007/s12519-025-00910-w.
The upper airway morphology in children varies with age and body position. This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under five.
This retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children's Hospital, Zhejiang University School of Medicine. Upper airway morphology was reconstructed using 3D Slicer software. Python was employed to estimate cross-sectional areas via pixel analysis. The narrowest cross-sectional area, minimal transverse and anteroposterior diameters, airway length, and airway volume were measured and stratified by age for subgroup analysis.
In sedated children under 5 years old and when compared to the supine position, lateral positioning increased minimal transverse diameter by 18.70% (P = 0.001), narrowest cross-sectional area by 49.21% (P < 0.001), anteroposterior diameter by 25.54% (P < 0.001), airway volume by 65.64% (P < 0.001), and airway length by 11.93% (P < 0.001). In all subgroups, lateral positioning significantly increased the narrowest cross-sectional area, airway length, and airway volume. However, minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3 -to 5-year age group tended to increase in the lateral position but did not reach statistical significance.
Lateral position significantly enlarges the upper airway in sedated children under five. These findings support using lateral position to enhance airway patency in younger patients.
儿童上气道形态随年龄和体位变化。本研究旨在分析侧卧位对五岁以下镇静儿童上气道的影响。
这项回顾性研究纳入了在浙江大学医学院附属儿童医院接受仰卧位和侧卧位MRI检查的儿科患者。使用3D Slicer软件重建上气道形态。采用Python通过像素分析估计横截面积。测量最窄横截面积、最小横径和前后径、气道长度及气道容积，并按年龄分层进行亚组分析。
在五岁以下镇静儿童中，与仰卧位相比，侧卧位使最小横径增加18.70%（P = 0.001），最窄横截面积增加49.21%（P < 0.001），前后径增加25.54%（P < 0.001），气道容积增加65.64%（P < 0.001），气道长度增加11.93%（P < 0.001）。在所有亚组中，侧卧位均显著增加了最窄横截面积、气道长度和气道容积。然而，1至3岁年龄组的最小前后径和3至5岁年龄组的最小横径在侧卧位时虽有增加趋势，但未达到统计学意义。
侧卧位可显著扩大五岁以下镇静儿童的上气道。这些发现支持采用侧卧位来提高年幼患者的气道通畅性。
