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Reappraising prone positioning for infants with Robin sequence: a cautionary tale
Archives of Disease in Childhood ( IF 5.2 ) Pub Date : 2021-10-01 , DOI: 10.1136/archdischild-2021-322151
Christian F Poets 1 , Cornelia Wiechers 2
Affiliation  

(Pierre-)Robin sequence (RS) is characterised by mandibular retrognathia, glossoptosis and upper airway obstruction (UAO). To alleviate the latter, placing such infants prone was already suggested as a first-line treatment by Robin himself, the eponym of this condition. Indeed, it appears intuitively plausible that gravity will help shifting the mandible forward during sleep. Against this background, it was not surprising that the prone position was implemented by about two-thirds of respondents to a recent survey focusing on interventions used in infants with RS.1 In neonatology, however, we have learnt the hard way that what seems plausible is not always effective and, particularly, safe. Thus, we need to scrutinise the evidence for recommending prone positioning to resolve UAO in infants with RS. Objective data on the effectiveness of this intervention, however, are sparse. A retrospective analysis of sleep study data in 18 infants with RS (mean age, 1.5 months) found a higher sleep efficiency in the prone position, but no significant reduction in the severity of obstructive sleep apnoea (OSA).2 A longitudinal prospective study in 14 infants with RS (mean age, 1.8 months) reported a median Obstructive Apnoea–Hypopnoea …

中文翻译:

重新评估罗宾序列婴儿俯卧位:一个警示故事

(Pierre-)Robin 序列 (RS) 的特点是下颌后缩、舌下垂和上气道阻塞 (UAO)。为了减轻后者,罗宾本人已经建议将这些婴儿俯卧作为一线治疗,这种情况的同名。事实上,从直觉上看,重力将有助于在睡眠期间向前移动下颌骨。在此背景下,在最近一项关注 RS 婴儿干预措施的调查中,约有三分之二的受访者采用俯卧姿势也就不足为奇了。并不总是有效,尤其是安全。因此,我们需要仔细审查推荐俯卧位来解决 RS 婴儿 UAO 的证据。然而,关于这种干预有效性的客观数据很少。对 18 名 RS 婴儿(平均年龄 1.5 个月)的睡眠研究数据进行的回顾性分析发现,俯卧位的睡眠效率更高,但阻塞性睡眠呼吸暂停 (OSA) 的严重程度没有显着降低。 2 一项纵向前瞻性研究14 名 RS 婴儿(平均年龄 1.8 个月)报告了中位阻塞性呼吸暂停 - 呼吸不足……
更新日期:2021-09-17
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