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Objective: To compare left lateral, right lateral, and pronenursing positions of neonate for reducing pre-feed gastricresiduals among ?34 weeks neonates.Design: Randomized crossover trial.Setting:Level-III NICU.Participants: Neonates ?34 weeks, receiving 50-150 mL/kg/day feeds through oro-gastric route.Intervention: Neonates were randomized to left lateral, rightlateral and prone positions. Intervention position was given foreight hours (4 feeds, 9AM to 5PM) followed by a wash-off period of16 hours. After 24 hours, each neonate crossed over to nextposition as per randomization card to complete three positions inthree consecutive days. Gastric residuals were collected justbefore next feed.Main outcome:Pre-feed gastric residuals.Results:Sixty three neonates were randomized. Fewer neonatesin right lateral position had gastric residuals compared to leftlateral position [OR 0.09 (95% CI 0.04, 0.21), P<0.001]. Neonatesin right lateral and prone positions had comparable gastricresiduals [OR 0.90 (95% CI 0.36, 2.22), P=0.82]. Gastricresiduals, as a proportion of last feed, were highest in left lateral[6% (2, 10), maximum 28%] position. Significantly higherproportion of neonates in right lateral position had episodes ofregurgitation compared to other positions. Oxygen saturation,heart rate, time to full feeds and duration of hospital stay werecomparable in the three groups.Conclusions: Left lateral position was associated with higher butclinically non-significant pre-feed gastric residuals as comparedto right lateral position. Right lateral position was associated withsignificantly increased regurgitation episodes
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Background:Capsule endoscopy( CE)has been widely used for the diagnosis of small intestinal diseases. How to enhance the complete examination rate( CER)has attracted more and more attention in recent years. Aims:To investigate the effect of different intervention on gastric transit time( GTT)and small bowel transit time( SBTT)in CE. Methods:Ninety patients undergoing CE from January 2012 to May 2013 at Changhai Hospital were enrolled and randomly divided into control group,right lateral position group and motion group. The patients in control group were allowed to keep quiet, patients in right lateral position group were asked to lie on their right side,and patients in motion group were asked to take rapid pace walking after swallowing the capsule until the capsule passing pylorus. GTT,SBTT,CER and disease diagnosis rate among the three groups were compared. Results:Compared with control group,GTT was significantly decreased in right lateral position group(P﹤0. 05),however,no significant difference in SBTT was found between right lateral position group and control group(P ﹥0. 05). GTT and SBTT were both significantly decreased in motion group than in control group(P﹤0. 05). No significant differences in CER and disease diagnosis rate were found among the three groups(P﹥0. 05). Conclusions:Right lateral position can shorten GTT,rapid pace walking can shorten GTT and SBTT,and both these two intervention have substantial clinical values in CE.
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ObjectiveTo investigate the clinical value of right lateral position with real-time monitor for capsule endoscopy.MethodsA total of 80 patients were randomly divided into two groups.The observation group assumed the right lateral position,while the control group was in upright,standing or sitting position.The capsule endoscope was monitored real time.The patients were allowed to move after the capsule endoscope passed pylorus.Gastric transit time,small bowel transit time,small bowel examination completion rate and positive detection rate were compared between the two groups.ResultsThe mean gastric transit time of the observation group was (31.7 ± 29.8)min,which was significantly shorter than that in the control group (62.6 ± 55.9) min ( U =559.000,P =0.020).The mean transit time of small bowel was (221.3 ±78.8) min in the observation group,which was not significantly different from that of the control group ( t =0.511,P =0.611 ).The examination completion rate of whole small bowel was 95.0％ (38/40)in the observation group,which was significantly higher than that of the control group (x2 =5.165,P =0.023).The positive detection rates were 75.0％ (30/40) and 65.0％ (26/40),respectively,which were not significantly different (x2 =0.952,P =0.329).ConclusionThe right lateral position with real-time monitor during capsule endoscopy is of better clinical value.
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BACKGROUND: Blood pressure measurement are used by medical purposes. Most clinical staffs assume that its values are accurate and reliable irrespective of the measured position. In order to measure blood pressure exactly the cuffed upper arm and the heart should be kept at the same level. However, sometimes the blood pressure must be taken with the patient lying on his/her side. In this lateral position it is difficult to set the cuff at the heart's level. PURPOSE: This study aims at applying exact measurements of blood pressure to practical use. Blood pressure measurements taken from the four extremities (right arm, left arm, right leg and left leg) in the lateral position are compared to those taken in the right arm in the supine position. METHODS: Thirty-one female and Thirty-two male subjects were sampled among fit students and the data were collected from May 7th, 2001 through June 7th, 2001. To begin with, the blood pressure of right arm in the supine position was measured. Then the blood pressure was measured again after 3 minutes in the subject's right lateral position. RESULTS: The blood pressure in the left arm in the right lateral position was lower than the right arm's blood pressure in the supine position (systolic difference=15.57 mmHg, diastolic difference=10.86 mmHg). DISCUSSION: Hydrostatic effects are the most likely cause of the drop in blood pressure of left arm in right lateral position. When blood pressure is measured in the left arm in the right lateral position, the position and site should be noted as well as the pressure may be 10mmHg or more lower than the precise blood pressure.