Adams J A, Zabaleta I A, Sackner M A
Department of Pediatrics, Mount Sinai Medical Center, Miami Beach, Florida 33140.
Pediatr Pulmonol. 1994 Jul;18(1):8-12. doi: 10.1002/ppul.1950180105.
The current study was undertaken to ascertain whether shift from supine to prone posture alters the pattern of natural breathing in healthy fullterm newborns. Breathing patterns were measured in the supine and prone posture in 20 healthy fullterm infants using calibrated, noninvasive respiratory inductive plethysmography (RIP). The values for breathing pattern components in supine and prone postures expressed as means (+/- SD) were, respectively, tidal volume (VT), 14.1(+/- 3.2) and 18.9(+/- 4.9)mL; mean inspiratory flow 26.7(+/- 11.5) and 32.8(+/- 13.0)mL/s; and minute ventilation 232(+/- 75) and 288(+/- 96)mL/kg/min (P < 0.01). Less thoracoabdominal incoordination, expressed as the labored breathing index (LBI), occurred with shift from supine to prone posture in infants studied in the active behavioral stage, changing from 2.0(+/- 0.5) to 1.3(+/- 0.4) (P < 0.01). Placement of a facemask-pneumotachograph system increased VT measured with RIP by 26% in the supine, and 18% in the prone posture. Neither respiratory rate nor inspiratory time (Ti) changed with the postural shift. Therefore, change from supine to prone posture improved ventilation and increased respiratory drive as expressed by VT/Ti. Further, thoracoabdominal incoordination which took place during active sleep in the supine posture, lessened with change to the prone posture.
本研究旨在确定从仰卧位转为俯卧位是否会改变健康足月儿的自然呼吸模式。使用校准的无创呼吸感应体积描记法（RIP），对20名健康足月儿在仰卧位和俯卧位时的呼吸模式进行了测量。仰卧位和俯卧位时呼吸模式各组成部分的值（以平均值±标准差表示）分别为：潮气量（VT），14.1（±3.2）和18.9（±4.9）mL；平均吸气流量，26.7（±11.5）和32.8（±13.0）mL/s；分钟通气量，232（±75）和288（±96）mL/kg/min（P<0.01）。在处于活跃行为阶段的婴儿中，从仰卧位转为俯卧位时，以呼吸费力指数（LBI）表示的胸腹不协调情况减少，从2.0（±0.5）变为1.3（±0.4）（P<0.01）。佩戴面罩-呼吸流速仪系统后，RIP测量的仰卧位VT增加了26%，俯卧位增加了18%。姿势改变时呼吸频率和吸气时间（Ti）均未改变。因此，从仰卧位转为俯卧位可改善通气，并增加以VT/Ti表示的呼吸驱动力。此外，仰卧位活跃睡眠期间出现的胸腹不协调情况，在转为俯卧位时有所减轻。
