{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T22:59:11Z","timestamp":1773442751771,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Prone positioning has been associated with improved oxygenation in ventilated newborn infants but the physiological basis of this improvement has not been previously studied. We aimed to test the hypothesis that respiratory function measured by composite physiological indices would be improved in the prone compared to the supine position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational study of ventilated newborns in a tertiary neonatal unit studied prone and supine at random order.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>The ventilation to perfusion ratio (V<jats:sub>A<\/jats:sub>\/Q) and right to left shunt were non\u2010invasively calculated using the oxyhemoglobin dissociation curve method. The gradient of the arterial to end tidal carbon dioxide (PaCO<jats:sub>2<\/jats:sub> \u2013 EtCO<jats:sub>2<\/jats:sub> gradient) was calculated to describe changes in the alveolar dead space.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six (26 male) infants with a median (IQR) gestational age of 34.8 (33.1\u201336.3) weeks and birth weight of 2.34 (1.77\u20132.87) kg were studied after 5 (2\u201310) hours of invasive ventilation. The V<jats:sub>A<\/jats:sub>\/Q was significantly higher in the prone position [0.57 (0.52\u20130.63)] compared to supine [0.53 (0.46\u20130.62), <jats:italic>p<\/jats:italic>\u2009=\u20090.001]. Right to left shunt was significantly lower in prone [7 (0\u201312) %] compared to supine [9 (1\u201316) %, <jats:italic>p<\/jats:italic>\u2009=\u20090.003]. The PaCO<jats:sub>2<\/jats:sub> \u2013 EtCO<jats:sub>2<\/jats:sub> gradient was significantly lower in prone [6.3 (3.8\u20138.4) mmHg] compared to supine [12.1 (7.1\u201316.0) mmHg].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prone position in ventilated neonates was associated with improved ventilation to perfusion matching and lower intrapulmonary shunting and alveolar dead space compared to supine.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.71075","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T15:37:06Z","timestamp":1743521826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Respiratory Function in Ventilated Newborn Infants Nursed Prone and Supine"],"prefix":"10.1002","volume":"60","author":[{"given":"Konstantina","family":"Barka","sequence":"first","affiliation":[{"name":"Department of Paediatrics Neonatal Intensive Care Unit Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Papachatzi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Neonatal Intensive Care Unit Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7617-9076","authenticated-orcid":false,"given":"Sotirios","family":"Fouzas","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Pediatric Pulmonology Unit Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Dimitriou","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Neonatal Intensive Care Unit Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5258-5301","authenticated-orcid":false,"given":"Theodore","family":"Dassios","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Neonatal Intensive Care Unit Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-320816"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003666.pub4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01639-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000507195"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1113\/EP089405"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25594"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000376567"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01388-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000528914"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17027"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-019-0342-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181c1b176"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.7.2011060"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14400"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-016-9969-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-018-0168-6"},{"issue":"4","key":"e_1_2_8_18_1","first-page":"375","article-title":"The PIO2 vs. SpO2 Diagram: A Non\u2010Invasive Measure of Pulmonary Oxygen Exchange","volume":"12","author":"Sapsford D. 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