SEARCH · PubMed Health

Results for “Prone Position”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources

PubMed1985

Seventeen-hour continuous esophageal pH monitoring in the newborn: evaluation of the influence of position in asymptomatic and symptomatic babies.

Esophageal pH monitoring has been performed in 60 asymptomatic neonates between 1 and 10 days old. Several parameters (periods with a pH less than 4, number of reflux episodes, number of reflux episodes lasting more than 5 min, average duration of the longest reflux episode, average pH) were studied in different positions (in prone and supine position, in right and left side lying position). For all parameters, except for the average pH, we obtained significantly more favorable results in prone position. In 22 vomiting neonates, significantly favorable results were obtained only by application of positional therapy: in prone position with head elevated (anti-Trendelenburg). There was no significant difference between the symptomatic group (with radiologically proven reflux pathology) in prone and anti-Trendelenburg position, and the control group in prone horizontal position. The 17-h continuous pH monitoring in the newborn is a nonaggressive investigation technique in physiological circumstances, which adequately completes and/or replaces the traditional examinations on gastroesophageal reflux. This method enables an evaluation of the favorable effect of simple therapeutic means (positional changes). Medication, and thickening and staggering of feeding (a time-consuming and tiring burden for the parents), can be avoided with this technique.

Esophagus↗

PubMed1987

Pathology of sudden infant death syndrome.

This study is based on 15 cases examined by the author. The majority of the infants were found in a prone position. Thymus was enlarged in all cases. Its enlargement of the lower portion overlying the basal portion of the heart formed an unyielding, tense membrane. In prone position, the heavy ventricles fell forward, producing angulation and kinking against this membrane and inhibited the filling of the heart or irritated the heart, producing arrhythmia and cardiac arrest.

Female↗

PubMed1997

Epidemiological features of sudden infant death after a German intervention campaign in 1992.

UNLABELLED: After national intervention campaigns, considerable declines in incidence for both sudden infant death (SID) and prone position have been observed worldwide. In the following investigation. German data on postinterventional risk factor patterns are presented for the first time. We analysed data from a 2-year population-based case-control study on SID carried out in two German districts between 1993 and 1994. We confirmed Complete covering of the baby (OR = 44.9, 95%-CI 95, 291), prone sleeping position (OR = 11.7; 5.3, 26.2), heavy maternal smoking during pregnancy (OR = 8.5; 3.2, 33.2 for > ten cigarettes per day), nonbreastfeeding (OR = 7.7; 2.7, 22.3) and missing maternal professional training (OR = 7.6; 3.6, 16.2) as risk factors for cot death. After adjustment for other major risk factors in a logistic regression model, sleeping on cushions lost statistical significance, whereas all other major risk factors remained relevant. CONCLUSIONS: Despite intervention campaigns, complete covering of the baby, prone position and heavy maternal smoking are still major risk factors for cot death. Except for sleeping on cushions, all major epidemiological risk factors for cot death act independently. Despite encouraging success in the reduction of risk factors for cot death, there is still substantial need for future endeavours towards a further reduction of modifiable risk factors for SID.

Bedding and Linens↗

PubMed1994

Morbidity associated with patient positioning in extracorporeal shock wave lithotripsy of distal ureteral calculi.

In 115 patients with 123 distal ureteral stones located below the lower border of the sacroiliac joint, in situ extracorporeal shock wave lithotripsy (ESWL) was performed with a Siemens Lithostar Lithotriptor. Our initial experience with the prone position in 8 out of 49 cases did not reveal stone fragmentation and on the final treatment sessions shock waves were allowed to enter via the obturator or sciatic foramen whilst the patients were in the supine position, in order to compare the results of treatments performed in both positions. The mean number of treatment sessions per patient, mean number of shock waves per treatment sessions, mean shock voltage per session and mean fluoroscopy time per session were significantly lower in the supine group than in the prone group (p < 0.05 for all variables). ESWL of the distal ureteral stones in the prone position seems to have an associated patient morbidity when we compare the results of treatments performed in both positions.

Female↗

PubMed2004

Gastric residual in growing preterm infants: effect of body position.

Studies of the effect of body position during and after bolus feeding upon gastric emptying or gastric residual have not had consistent results. We tested the hypotheses that right lateral decubitus leads to less gastric residual than left lateral decubitus and that the prone position leads to less gastric residual than the supine position. A prospective randomized clinical trial with triple crossover of healthy growing, appropriate for gestational age preterm infants. Each infant was successively studied while fed in the four different positions. Gastric residuals were measured at 1 and 3 hours after initiation of feeding and returned. Thirty-one patients were studied. At 1 hour, right lateral decubitus led to less significant residuals than the left lateral decubitus and the prone position led to less residual than the left lateral decubitus. The amount of gastric residuals 1 hour after a meal appears to be in the following decreasing order: left, supine, prone, right.

Cross-Over Studies↗

PubMed1979

Postural reflexes in man.

In 40 adult patients stabilized on the tilt table, no evidence was found that the amount of activity at rest in spastic muscles depends on the position of the head in space. The influence of postural labyrinthine reflexes (Magnus) was not confirmed. The activity in spastic extensor muscles was significantly higher (t greater than 1%) in the prone position. The activity in spastic flexor muscles was higher (t greater than 1%) in the supine position. Extralabyrinthine forces (tonic stretch reflexes and exteroceptive reflexes) are assumed to be decisive in these changes. In the same group of patients, the symmetric deep neck reflexes were examined. The patient actively flexed his head forwards or backwards. Significant increase in the activity at rest in spastic extensor muscles on dorsal flexion of the head in the prone position was found (t greater than 1%). Significant increase in the activity at rest in spastic flexor muscles on ventral flexion of the head in the supine position was also found (t greater than 5%). The phenomena of irradiation are assumed to be decisive in these changes. In another group of 27 adults the asymmetric deep neck reflexes (Magnus and De Kleijn) were examined. The patient actively turned his head either to the left or to the right, while his arms were raised (Hoff-Schilder maneuver). When the degree of rotation of the head was slight, the trunk and arms deviated in the same direction. When the rotation of the head was extreme, and reached behind the shoulder, the trunk and arms often reversed the direction of deviation. The effect of asymmetric deep neck reflexes was not confirmed. Visual perception and the mechanism of focusing are assumed to be decisive in these changes. The head turns toward the object of interest in the visual field by the mechanism of eye-centering (Bender) and influences the position of the trunk and motor patterns of the upper extremities (motor principle "eyes-hand").

Adolescent↗

PubMedDate not supplied

[Ischemia of the brain stem caused by compression of the vertebral arteries by head rotation--an etiology for SIDS?].

UNLABELLED: Hypoperfusion of the brainstem during head rotation may be a risk factor for the development of SIDS. On this background we established a Doppler sonographic screening programme of the basilar cerebral arteries to evaluate the dependency of blood flow on head and body position. PATIENTS AND METHOD: We investigated 3840 newborns (1872 girls and 1968 boys) with a birth weight of 3399 +/- 497 g and a gestational age of 39.2 +/- 1.4 weeks. The investigations were performed in the neonatal period with an average age of 4.7 +/- 3 days. In all infants blood flow was measured in the basilar artery (BA) in supine position with the head in the midline. From the flow profile peak systolic flow velocity Vs and time average flow velocity TAV were measured. Additionally flow measurements were performed in supine and prone position with rotation of the head to the right and left side. A decrease of blood flow velocities below 50% of the value in neutral position was considered to be abnormal. Retrograde or biophasic flow profiles during rotation were considered to be pathologic. In infants with abnormal or pathologic flow during rotation of the head flow measurements in the vertebral arteries (VA) were additionally performed. Blood flow velocities in the VA were measured in supine and prone position with the head in the midline position and after rotation to the right and to the left. In neutral position unilateral vertebral hypoplasia, aplasia and normal VA were differentiated. The judgement after rotation was performed such as in the BA. RESULTS: In 3807 infants (99.14%) blood flow velocities during head rotation did not decrease below 50% of the value measured in neutral position. In 33 infants (0.86%) a decrease of blood flow velocities below 50% could be found during rotation. In 7 infants (0.18%) a pathologic flow could be found during head rotation. 27 of the 33 infants with abnormal and pathologic blood flow in the BA during rotation showed anatomic abnormalities of the VA. 20 of these infants (61%) had unilateral vertebral hypoplasia (11 right, 9 left side), 7 (21%) had unilateral vertebral aplasia (4 right, 3 left side). 32 of the 33 infants with abnormal flow in the BA showed a decrease of blood flow in the contralateral VA during head rotation. 9 infants had an abnormal, 19 a pathologic flow within the contralateral VA. In 4 infants the corresponding VA could not be measured during head rotation. The decrease of blood flow velocities in the BA during head rotation was caused by compression of the contralateral VA at the craniocervical junction. CONCLUSION: Blood flow within the basilar artery of healthy infants is independent of body position and rotation of the head. A decrease of the flow velocities below 50% during rotation has to be considered as an abnormality. The incidence of pathologic blood flow during head rotation with 1.8@1000 approximates the incidence of SIDS. Hypoperfusion of the brainstem during head rotation may be a risk factor of SIDS.

Blood Flow Velocity↗

PubMedDate not supplied

Reduction of posterior hip dislocations in the lateral position using traction-countertraction: safer for the surgeon?

Closed reduction of a hip dislocation is a physically demanding task for the orthopaedic surgeon. The most commonly used methods for reduction of the hip involve vigorous axial traction on the lower extremity with the patient in the supine position, using an assistant who attempts to hold the pelvis down. The surgeon generally stands over the patient to pull up on the bent knee, which puts the surgeon at risk for a low back injury and, if done while the patient remains on a stretcher, can put the surgeon at risk for a fall from a height. Reduction in the prone position is advocated by some, but caring for the sedated patient in the prone position can be difficult and the patient's pelvis tends to roll off the edge of the stretcher, preventing the achievement of hip flexion, which is desirable in achieving reduction. We describe a traction-countertraction technique that appears to be significantly less dangerous for the surgeon. In this technique the hip is reduced with the patient remaining on the stretcher in the lateral position. In addition, fluoroscopy can be carried out during the reduction maneuver, and the images can be quite helpful in adjusting the direction of manipulative forces.

Hip Dislocation↗

PubMed1995

[Comparative studies on a single dose toxicity of microsomal Ca(2+)ATPase inhibitor, 2,5-di(tert-butyl)-1,4-hydroquinone and its related analog, mono(tert-butyl)-1,4-hydroquinone, in rats].

We performed comparative studies to determine an acute toxicity of microsomal Ca(2+)ATPase inhibitor, 2,5-di(tert-butyl)-1,4-hydroquinone (DTBHQ) and its related analog, mono(tert-butyl)-1,4-hydroquinone (MTBHQ), which are both used as antioxodants. Wistar rats, 5 weeks old, male and female, were used. By a single dose of oral administration, DTBHQ-induced LD50 values (obtained by Lorke method) in male and female rats were estimated 295.1 and 234.4 mg/kg BW, respectively, whereas each LD50 value for MTBHQ was 711.6 and 400.0 mg/kg BW, respectively. MTBHQ-induced deaths occurred from 8 to 20 minutes after administration, however, DTBHQ-induced deaths occurred more delayed from 1 to 5 days after administration. The observed toxic signs of DTBHQ included diarrhea (jelly like), prone position, lacrimation, salivation and abnormal gait (such as reluctance to walk, limping). Localized purpura and loss of the tail (perhaps as a result of necrosis) were also observed. In comparison, MTBHQ elicited prone position, panting, staggering gait and spastic gait. Without loss of the tail montioned above, dead and sacrified rats showed no remarkable changes in macroscopic examination due to exposure to both compounds.

Administration, Oral↗

PubMed2002

[Stereotactic vacuum biopsy in prone and sitting position].

PURPOSE: The purpose of our study was to determine the accuracy of vacuum-assisted biopsy (VB) and to evaluate the side effects of this method depending on the positioning of the patient during the intervention. METHODS: Interventions were performed with the 11-G biopsy needle either in prone position (Mammotest S, Fischer Imaging, USA) on a dedicated table for breast intervention (n = 308) or in upright position with a dedicated digital stereotactic mammography system (Mammomat 3000, Optima, Siemens, Germany). VB was indicated because of indeterminate or suspicious microcalcifications (84.1%) or because of dense lesions (15.9%). All benign results found with VB have been followed up after 6 and 12 months by mammography. All malignant or histological findings discordant to imaging features have been verified by open surgery. RESULTS: Histology after VB offered 215 (64.4%) benign lesions. In neither case a carcinoma developed during follow-up. In 90 (27%) cases malignancy was found with VB. After reexcision the diagnosis of VB was confirmed in 85.6%. In 8.9% of the cases in which VB showed DCIS, histology after open surgery revealed also invasive tumor components. Technical problems occurred in 4 cases. Major side effects developed neither in prone position nor in upright, sitting position of the patient. CONCLUSION: VB is a reliable method with less side effects for the histological evaluation of breast lesions. The accuracy and complications are not depending on the type of stereotactic device or on the patients position. The accuracy of the histological diagnosis achieved with VB can be compared to that of open surgery. The relative high costs of this method may cause a problem. But compared to the costs resulting by open diagnostic surgery this disadvantage is only a relative one.

Adult↗

PubMed1984

Prone computed tomography metrizamide myelography: a technique for improved diagnosis of lumbar disc herniation.

Computed tomography metrizamide myelography of the lumbar spine in the prone position is advocated for better visualisation of the thecal sac-disc annulus interface. This method allows a more precise diagnosis of disc herniation. Therefore, it is suggested that this technique should routinely be performed prone. In cases where suspended respiration in the prone position is difficult, the same result may be achieved by patient movement before scanning in the supine position.

Humans↗

PubMed2006

"The disappearing evoked potentials": a special problem of positioning patients with skeletal dysplasia: case report.

STUDY DESIGN: A retrospective study of 3 patients with skeletal dysplasia, who had a loss of the evoked potentials during prone positioning before spine surgical intervention. OBJECTIVES: To bring attention to the potential hazard of neurologic compromise during the positioning of patients with skeletal dysplasia for spine surgery. Recommendations are suggested to prevent the disappearance of intraoperative evoked potentials and, therefore, possible neural injury in these patients. SUMMARY OF BACKGROUND DATA: In a very few published cases, loss or attenuation of monitored potentials has been observed at the time of initial patient positioning. Although patients with skeletal dysplasia might be considered particularly vulnerable to spinal cord injury caused by malpositioning of the head and neck, to our knowledge, no association with lost evoked potentials has previously been described. METHODS: Intraoperative transcranial electrical motor-evoked potential and/or somatosensory evoked potential baseline studies were performed after induction in the supine position. These studies were repeated as soon as practicable, after intubation and, again, after the patients were turned prone. The neurophysiologist informed the surgeon that evoked potential change in latency or amplitude met warning criteria. Alteration in the surgical plan resulted in successful spinal surgery in these cases. RESULTS: In case No. 1, repositioning of the head in flexion was sufficient to return the evoked potentials to normal. In the other two cases, attempts to reposition the patients prone failed, and the procedures were abandoned. In case No. 2, four months after the initial surgery, a halo cast for immobilization and craniocervical decompression were needed before the corrective cervical spine surgery, and in case No. 3, two steps were taken after the initial surgery: 1) trial positioning awake on the surgical table before surgery; and 2) awake postintubation prone positioning on the actual surgery day. CONCLUSIONS: Patients with skeletal dysplasia are susceptible to serious neurologic misadventure when turned to a prone position. Neurophysiologic and/or clinical monitoring of patient positioning should be undertaken, and a plan of intervention, should loss of signal or function occur, must be implemented.

Adult↗

PubMed2001

Using a belly board device to reduce the small bowel volume within pelvic radiation fields in women with postoperatively treated cervical carcinoma.

OBJECTIVE: The purpose of this study was to attempt to reduce the small bowel volume in cervical cancer patients undergoing radiation therapy using the belly board device and a four-field technique. METHODS: From 1994 through 1997, twenty-one patients with cervical cancer were referred to the University of Minnesota Medical Center and underwent surgical staging with or without radical hysterectomy followed by postoperative external beam radiotherapy for various indications including positive nodal disease (n = 11), lymph-vascular space invasion (n = 2), poor histology (n = 3), parametrial disease (n = 4), and positive vaginal margin (n = 1). RESULTS: The median age of the 21 patients was 42 years (25-54 years) and a median external beam pelvic radiation dose of 4775 cGy (range, 4200-5075 cGy) was administered. All patients were evaluated for amount of small bowel in the field in both the supine and prone positions, with and without the belly board device (BBD), using a four-field technique. With a full bladder, abdominal radiographs with contrast were obtained to evaluate the volume of small bowel within the radiation fields. In most patients, the BBD was effective at minimizing the amount of small bowel in the lateral fields, whereas a prone position on the treatment table (without the BBD) spared the most small bowel with the AP/PA fields. Therefore over a 2-day cycle, the most small bowel sparing was obtained with the patients treated prone on the BBD for the lateral fields on Day 1 and prone on the table for the AP/PA fields on Day 2. Patients had FIGO stage IB (n = 18), IA2 (n = 1), and IIA (n = 2). The median follow-up was 37 months (24-65 months). No significant acute gastrointestinal or genitourinary toxicity was experienced and no patients have experienced a bowel obstruction to date. CONCLUSIONS: The BBD may offer a means for positioning the mobile small intestine out of the radiation field and improving the tolerance of radiotherapy. The BBD provides a noninvasive technique for reduction of acute and chronic gastrointestinal morbidity.

Adult↗

PubMed2000

Effects of positive end-expiratory pressure ventilation on cerebral venous pressure with head elevation in dogs.

Mechanical ventilation with positive end-expiratory pressure (PEEP) may prevent venous air embolism in the sitting position because cerebral venous pressure (Pcev) could be increased by the PEEP-induced increase in right atrial pressure (Pra). Whereas it is clear that there is a linear transmission of the PEEP-induced increase in Pra to Pcev while the dog is in the prone position, the mechanism of the transmission with the dog in the head-elevated position is unclear. We tested the hypothesis that a Starling resistor-type mechanism exists in the jugular veins when the head is elevated. In one group of dogs, increasing PEEP linearly increased Pcev with the dog in the prone position (head at heart level, slope = 0.851) but did not increase Pcev when the head was elevated. In another group of dogs, an external chest binder was used to produce a larger PEEP-induced increase in Pra. Further increasing Pra increased Pcev only after Pra exceeded a pressure of 19 mmHg (break pressure). This sharp inflection in the upstream (Pcev)-downstream (Pra) relationship suggests that this may be caused by a Starling resistor-type mechanism. We conclude that jugular venous collapse serves as a significant resistance in the transmission of Pra to Pcev in the head-elevated position.

Animals↗

PubMed1990

The effects of prone and supine positioning on arterial oxygen pressure.

An experimental study was conducted on 25 ventilated premature infants with RDS comparing PaO2 in the supine and prone positions. Analysis of the mean PaO2 showed significantly higher values in the prone position (p = .005). It is important for nurses to be aware of the implications of positioning on respiratory functioning and to integrate this knowledge in their practice.

Blood Gas Analysis↗

PubMed1985

Is obligatory bed rest after lumbar puncture obsolete?

After lumbar puncture (LP) an epidural CSF leakage caused by delayed closure of a dural defect leads to a decrease in CSF pressure. The resultant venous dilatation as well as downward shift of the brain with traction on pain-sensitive blood vessels and nerves frequently evokes post-lumbar puncture headache (PLPH), when the patient assumes the upright position. In previous studies differing opinions have been expressed about the prophylactic value of the posture taken by the patient after LP. The present study was designed to evaluate the benefit of the decrease of hydrostatic CSF pressure on the dural rent, when the patient lies down in a prone position with the head tilted down at an angle of 10 degrees for 30 min immediately after LP: is it possible to accelerate the closure of the dural defect in this way and prevent PLPH? One group of patients (n = 78) lay in a prone position with the head tilted down at an angle of 10 degrees for 30 min, the other group (n = 82) rose immediately after LP. PLPH was found to be independent of the posture in both groups and affected 44% and 41% of the patients, respectively, so that there is no longer any justification for requiring patients to remain in bed after LP.

Adolescent↗

PubMed1983

Irradiation of true pelvis for bladder and prostatic carcinoma in supine, prone or Trendelenburg position.

Small bowel transit was performed in 50 patients with bladder or prostatic carcinoma. The patients were all examined in supine and prone positions; some were also studied in 25 degrees Trendelenburg position and 25 degrees inclined procubitus to investigate the effect of the various positions on the displacement of the small bowel loops out of the true pelvis. The prone position proved to be superior to the supine position in 78% of patients. A mean displacement of 0.9 cm was obtained. Greatest shifts generally were found in the Trendelenburg position and inclined procubitus, with a mean displacement of 1.9 and 2.0 cm, respectively. The patients' height, weight, maximal abdominal circumference and Quetelet's index were analyzed with regard to the shifts of bowel loops under the various conditions. Only weight and Quetelet's index were correlated with the shifts in the Trendelenburg and inclined procubitus positions. The shifts were generally larger in case of heavier patients. We conclude that pelvic irradiation should preferably be done in the Trendelenburg or inclined procubitus position, especially in case of obesity.

Body Height↗

PubMed1999

Demonstration of gravity-dependent lung perfusion with contrast-enhanced magnetic resonance imaging.

Imaging of lung perfusion using contrast-enhanced dynamic magnetic resonance (MR) was performed in both the supine and prone positions in six volunteers. Regions of interest (ROIs) were chosen in the dependent and non-dependent portions of the right lung. The percentage increase in signal intensity (SI) and the mean slope were calculated. In the supine position, the dorsal ROI had a greater increase in SI (236.0% vs. 156.9%, P < 0.05) and a faster rise in the slope of enhancement (55.1%/sec vs. 30.1%/sec, P < 0.05) than the ventral ROI. After changing to the prone position, higher peak enhancement (234.3% vs. 177.4%, P < 0.05) and faster slopes (59.6%/sec vs. 35.3%/sec, P < 0.05) shifted to the anterior ROI. We conclude that dynamic contrast-enhanced MR imaging is sensitive to demonstrate gravitationally dependent differences in lung perfusion.

Adult↗