***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study was to determine the effects of body position ( supine vs prone ) on cardiorespiratory activity during quiet and active sleep in growing low birth weight ( LBW ) infants . The effect of postconceptional age on cardiorespiratory activity in the two positions was also evaluated . Fifty-one healthy , growing , appropriate for gestational age LBW infants ( 795 - 1600 g ) , ranging from 26 - 37 weeks in gestational age , were evaluated . All subjects were enrolled in an ongoing study of the effects of quality of dietary energy on the rate and composition of weight gain . Infants were r and omly assigned to the supine or prone position for the first 3 h of the 6-h studies ; the position was reversed for the second 3 h. Continuous recordings of cardiorespiratory activity were performed along with simultaneous minute by minute assignment of behavioral sleep state . Measurements of heart rate ( HR ) , heart period variability ( RR-SD ) , respiratory rate ( f ) , and respiratory variability ( fSD ) were made each minute . Low birth weight infants had higher HR and f and lower RR-SD and fSD in the prone position compared to the supine position , during both quiet and active sleep . With increasing postconceptional age , positional differences in HR increased during quiet sleep and differences in RR-SD increased during both sleep states . These data demonstrate systematic differences in cardiorespiratory control related to body position during sleep . We speculate that such positional differences are due to variations in autonomic control , and may , in turn , contribute to variations in susceptibility to sudden infant death syndrome Objective : To describe the effects of prone positioning on airway management , mechanical ventilation , enteral nutrition , pain and sedation management , and staff utilization in infants and children with acute lung injury . Design : Secondary analysis of data collected in a multiple-center , r and omized , controlled clinical trial of supine vs. prone positioning . Setting : Seven pediatric intensive care units located in the United States . Patients : One hundred and two pediatric patients ( 51 prone and 51 supine ) with acute lung injury . Interventions : Patients r and omized to the supine group remained supine . Patients r and omized to the prone group were positioned prone per protocol during the acute phase of their illness for a maximum of 7 days . Both groups were managed using ventilator and sedation protocol s and nutrition and skin care guidelines . Measurements and Main Results : Airway management and mechanical ventilatory variables before and after repositioning , enteral nutrition management , pain and sedation management , staff utilization , and adverse event data were collected for up to 28 days after enrollment . There were a total of 202 supine-prone-supine cycles . There were no differences in the incidence of endotracheal tube leak between the two groups ( p = .30 ) . Per protocol , 95 % of patients remained connected to the ventilator during repositioning . The inadvertent extubation rate was 0.85 for the prone group and 1.03 for the supine group per 100 ventilator days ( p = 1.00 ) . There were no significant differences in the initiation of trophic ( p = .24 ) , advancing ( p = .82 ) , or full enteral feeds ( p = .80 ) between the prone and supine groups ; in the average pain ( p = .81 ) and sedation ( p = .18 ) scores during the acute phase ; and in the amount of comfort medications received between the two groups ( p = .91 ) . There were no critical events during a turn procedure . While prone , two patients experienced an obstructed endotracheal tube . One patient , supported on high-frequency oscillatory ventilation , experienced persistent hypercapnea when prone and was withdrawn from the study . The occurrence of pressure ulcers was similar between the two groups ( p = .71 ) . Compared with the supine group , more staff ( p ≤ .001 ) and more time were necessary to reposition patients in the prone group . Conclusions : Our data show that prone positioning can be safely performed in critically ill pediatric patients and that these patients can be safely managed while in the prone position for prolonged periods of time Eighteen stable very-low-birth-weight ( VLBW ) mechanically ventilated infants with chronic lung disease were studied to examine the effects of right and left lateral positioning in contrast to supine positioning on transcutaneous ( tc ) oxygen ( tcPO2 ) and carbon dioxide measurements ( tcPCO2 ) .  The neonates were studied at a median postnatal age of 31 days ( range , 17 to 57 days ) and had median birth weights and gestational ages of 975 g ( range , 570 to 1360 g ) and 27.5 weeks ( range , 24 to 30 weeks ) , respectively .  Median fraction of inspiratory oxygen was 0.32 ( range , 0.23 to 0.40 ) . The sequence of study positions was r and omly determined . Sleep state as well as tcPO2 and tcPCO2 were recorded every 30 s for five minutes . A significant difference in mean tcPO2 or tcPCO2 was not detected for any of the positions . Lateral positioning may facilitate the development of midline behavior in VLBW infants . Care givers are often reluctant to position infants in side lying , however , because of concerns that ventilation or oxygenation might be compromised . We conclude that placing the stable VLBW mechanically ventilated infant in a side-lying position has no deleterious effects on oxygenation and ventilation , as measured by tcPO2 and tcPCO2 , and therefore should be encouraged STUDY OBJECTIVES Investigating the effect of low-volume pressure-limited ventilation and repeated prone positioning on the short-term course and outcome in patients with severe ARDS . SETTING Level 1 trauma center of a university hospital . PATIENTS Twenty-five patients suffering from ARDS with a lung injury score ( LIS ) > or = 2.5 admitted consecutively to our ICU from January 1992 to December 1994 . METHODS Mechanical ventilation with peak inspiratory pressure limitation to 35 mbar , irrespective of hypercapnia and prone positioning to achieve adequate oxygenation . SCORING AND MEASUREMENTS : Patient assessment with LIS , APACHE ( acute physiology and chronic health evaluation ) II score , injury severity score , and multiple organ failure score . Blood gas analyses  and estimation of static compliance were repeated at least every 4 h during the treatment period . PaO2/FIO2 ( fraction of inspired oxygen ) ratio , alveolo-arterial oxygen difference , and intrapulmonary shunt were calculated according to st and ard equations . The best values taken from each 4-h period during the investigation were used to evaluate the best possible performance of the lung within this interval and to investigate the entire course . RESULTS Mean predicted mortality based on the APACHE II score was 35.4+/-15.2 % . Three of the 25 patients ( 12 % ) died . However , none was related to respiratory failure . No pneumothorax occurred . Sixteen patients , lacking any contraindication for prone positioning , responded positively to this change in position , each to a different individual degree . CONCLUSION We assume that our low mortality in patients with severe ARDS might be due mainly to low-volume pressure-limited ventilation and prone positioning . This simple strategy seems to allow successful treatment for patients with severe ARDS BACKGROUND AND PURPOSE Body position can play an important role in an infant 's recovery from respiratory disease , but few studies have accounted for sleep state which is known to have a direct influence on the control of respiratory muscles as well as on metabolic and circulatory changes . The purpose of this study was to examine the influence of body position on respiratory function in pre-term infants whilst accounting for sleep state . METHOD Thoraco-abdominal motion was assessed using respiratory inductance plethysmography ( RIP ) to provide measures of relative rib cage ( RC ) and abdominal ( AB ) movement in ten non-ventilated pre-term infants . Continuous measurements of oxygen saturation ( SaO2 ) , pulse and heart rate ( HR ) , were made and sleep state was recorded using behavioural criteria and electro-oculogram ( EOG ) measurements . RESULTS The results showed a significant increase in HR in supine , but no significant difference in SaO2 as a function of position , compared to the prone position where a significant reduction was found in thoraco-abdominal asynchrony for both groups and a reduction in variability in both HR and SaO2 . Intra-subject variability of thoraco-abdominal motion as a function of position demonstrated no significant difference on return to supine or on return to prone , illustrating good repeatability of measures . CONCLUSIONS Prone positioning of pre-term infants recovering from respiratory disease may improve respiratory function . As measured , the improvement in respiratory synchrony in prone position brings pre-term infants ' breathing pattern into line with that expected in term infants AIM --To investigate whether nursing position has any effect on the frequency , type , and duration of apnoeas in preterm infants . METHOD --Thirty five preterm infants were entered into a crossover study and underwent polygraphic monitoring in each of two positions , prone and supine , the initial position being r and omly allocated . Four parameters were recorded : nasal airflow , respiratory effort , electrocardiogram ( ECG ) , and oxygen saturation . Each infant was studied in the two positions on the same day and each infant was studied only once . The studies were carried out on the neonatal intensive care unit . RESULTS --The infants were found to have significantly more central and mixed apnoeas in the supine than in the prone position . In addition , the severity of mixed apnoeas in terms of the duration of accompanying bradycardias and desaturations was greater in the supine than in the prone position ( median difference 5.1 seconds in both instances ) . When considering the type of apnoea in relation to the duration , it was found that of those less than 20 seconds in duration there was a greater proportion that were central ( 25 % ) compared with the proportion of central ( 5 % ) apnoeas that were longer than 20 seconds . Of all the apnoeas that were less than 20 seconds in length , 16 % were obstructive and 59 % were mixed , whereas of the apnoeas greater than 20 seconds , 13 % were obstructive and 82 % were mixed . CONCLUSIONS --It appears that in addition to improving measures of lung function , the adoption of the prone nursing position for preterm infants may reduce associated problems of apnoea of prematurity 
    Output:
    
There were no statistically significant differences between any other positions .
The prone position was significantly superior to the supine position in terms of oxygenation .
However , as most participants were ventilated preterm infants , the benefits of prone positioning may be most relevant to these infants .