Effect of sleeping position on cardiac output, pulmonary pressure, and superior vena cava flow in healthy term infants

Muhammed Karabulut; Hasan Sinan Uslu

doi:10.1016/j.pedneo.2023.09.003

Effect of sleeping position on cardiac output, pulmonary pressure, and superior vena cava flow in healthy term infants

Pediatr Neonatol. 2023 Oct 21:S1875-9572(23)00184-5. doi: 10.1016/j.pedneo.2023.09.003. Online ahead of print.

Authors

Muhammed Karabulut¹, Hasan Sinan Uslu²

Affiliations

¹ Department of Paediatric Cardiology, Clinical of Paediatric Health and Diseases, Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey. Electronic address: muhammedkarabulut@gmail.com.
² Department of Neonatal İntensive Care, Clinical of Paediatric Health and Diseases, Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

PMID: 37973502
DOI: 10.1016/j.pedneo.2023.09.003

Abstract

Background: Although the mechanism of action in newborns is unknown, sleep positioning is associated with many pathophysiological events. This study aimed to compare the effects of supine and prone sleeping positions on cardiac output (CO), systolic pulmonary arterial pressure (SPAP), and superior vena cava (SVC) flow in healthy newborns.

Methods: In the first 24-72 h of life, 40 healthy term newborns born in the same hospital were included in this prospective, cross-sectional, observational study. CO, SVC flow, and SPAP values of newborns in the supine and prone sleeping positions were calculated using echocardiographic examination. The measurements were statistically compared.

Results: In the supine sleeping position, CO, SVC flow, and SPAP were 235.00 (193.07-283.30) ml/kg/min, 92.80 (77.82-121.87) ml/kg/min, and 27.85 (24.70-30.48) mmHg. In the prone sleeping position, CO, SVC flow, and SPAP were measured as 195.35 (166.00-229.40) ml/kg/min, 67.25 (51.82-96.66) ml/kg/min, 31.60 (28.45-37.20) mmHg, respectively. Depending on sleeping position, these variables were significantly different between the groups.

Conclusion: SVC flow and CO decreased in the prone sleeping position compared to the supine sleeping position in healthy newborns, whereas SPAP increased. The different hemodynamic effects of sleeping position on the cardiac, pulmonary, and nervous systems should be considered as flow and pressure changes are important in newborns.

Keywords: Cardiac output; Newborn; Pulmonary pressure; SVC flow; Sleeping position.