Archives of disease in childhood
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The physiological basis underlying the decline in the incidence of sudden infant death syndrome (SIDS) associated with changing the sleep position from prone to supine remains unknown. ⋯ In healthy term infants, placed in the prone position, the diaphragm is significantly thicker and, therefore, shorter, both at EEV and EIV. Diaphragm shortening during tidal breathing is greater when the infant is prone. In the prone position, the decreased diaphragm resting length would impair diaphragm strength, and the additional diaphragm shortening during tidal breathing represents added work performed by the diaphragm. This may compromise an infant's capacity to respond to stressful situations when placed in the prone position and may contribute to the association of SIDS with prone position.
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Comparative Study
Comparison of the pressure time product during synchronous intermittent mandatory ventilation and continuous positive airway pressure.
To compare the effect of continuous positive airway pressure (CPAP) with synchronous intermittent mandatory ventilation (SIMV) during weaning, by measurement of the pressure time product (PTP). The PTP is an estimate of the metabolic work or oxygen consumption of the respiratory muscles. ⋯ These results suggest SIMV, rather than CPAP, may be the more efficacious weaning mode in children, and that the time spent on CPAP during weaning should be minimised.