ABSTRACT
A crossover, quasi-experimental design was conducted to evaluate the optimal posture among four positions (supine, prone, left lateral, and right lateral) in preterm infants within 48 hours postextubation. Oxygen saturation, respiratory rate, and Silverman-Anderson retraction score were utilized to evaluate the optimal posture. Fifteen preterm infants, thirteen male and two female, with a mean birthweight of 1,251 g (range 610-1,800 g), a mean postnatal age of 18.87 days (range 2-39 days), and a mean postextubation period of 23.5 hours (range 6-38 hours) were studied. Seven infants suffered respiratory failure from respiratory distress syndrome, three from pneumonia, two from perinatal asphyxia, and one from each of the following disorders: patent ductus arteriosus, pneumothorax, and apnea. Each infant was randomly assigned to each position. Oxygen saturation, respiratory rate, and Silverman-Anderson retraction score were recorded when the seconds. Significant differences in mean oxygen saturation and Silverman-Anderson retraction score were not detected for any positions (p = 0.377 and p = 0.51, respectively) but postures did influence respiratory rate (p = 0.001). The mean respiratory rate was 58.9 breaths per minute (bpm) in left lateral position, and 59.9 bpm in right lateral position both being significantly higher than the mean respiratory rate of 54.2 npm in supine position (p = 0.003 and 0.007, respectively). In prone position, the mean respiratory rate was 57.2 bpm which was not significantly different from the mean respiratory rate in supine position (p = 0.059). We conclude that the appropriate posture for preterm infants during the 48-hour postextubation period is all four postures positioned alternately. It there is any deterioration in oxygen saturation in any particular posture, that specific posture should be avoided.