Document Detail

Prone position increases collapsibility of the passive pharynx in infants and small children.
MedLine Citation:
PMID:  12204878     Owner:  NLM     Status:  MEDLINE    
On the basis of two observations that avoiding prone sleeping decreased incidence of sudden infant death syndrome and that obstructive sleep apnea is closely linked with the syndrome, we hypothesized that the prone position may increase upper airway collapsibility in infants and small children. Passive pharyngeal collapsibility of 19 infants and small children (10-101 weeks old) was examined in three postures: supine with face straight up, supine with neck rotated, and prone with neck rotated. The collapsibility was evaluated with the maximal distension of the most collapsible region, pharyngeal stiffness, and pharyngeal closing pressure, estimated from static pressure-area relationship of the passive pharynx. No significant changes in pharyngeal stiffness were detected; however, maximal distension was reduced in the prone position (mean +/- SD, 0.56 +/- 0.26 versus 0.44 +/- 0.20 cm(2); supine with face straight up versus prone position, p < 0.05). Pharyngeal closing pressure increased at neck rotation in the supine position (-4.5 +/- 2.4 versus -2.8 +/- 2.3 cm H(2)O; supine with face straight up versus supine with neck rotated, p < 0.05), and a further increase was observed in the prone position (-0.3 +/- 2.9 cm H(2)O, p < 0.05 versus supine with neck rotation). Pharyngeal closing pressure in the prone position was above atmospheric pressure in half of our subjects, whereas all subjects had negative pharyngeal pressure in the supine position. We conclude that the prone position increases upper airway collapsibility, although the mechanism is yet unclear.
Teruhiko Ishikawa; Shiroh Isono; Junko Aiba; Atsuko Tanaka; Takashi Nishino
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  166     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-02     Completed Date:  2002-10-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  760-4     Citation Subset:  AIM; IM    
Department of Anesthesiology (B1), Graduate School of Medicine, Chiba University, Chiba, Japan.
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MeSH Terms
Airway Resistance / physiology*
Child Development / physiology
Child, Preschool
Palate, Soft / physiopathology*
Pharynx / physiology*
Prone Position*
Prospective Studies
Respiratory Mechanics
Risk Assessment
Sampling Studies
Sudden Infant Death / etiology,  prevention & control
Supine Position

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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