Positioning and the Spontaneous Breathing Test in Neonates

Evaluation of the Influence of Positioning and Time Duration on the Spontaneous Breathing Test in Neonates

The spontaneous breathing test (SBT) is routinely performed on all intubated patients in the NICU who are potential candidates for extubation from mechanical ventilatory support. For all parents who consent, the routine SBT will be performed on all infants. In addition to the routine SBT the following will occur:

1. work of breathing indices: obtained non-invasively through respiratory inductive plethysmography (RIP).
2. Performing the SBT in the prone position, in addition to the routine position (supine).

Inclusion Criteria:

• Infants who qualify for SBT as part of their normal care

Exclusion Criteria:

• Previous history of abdominal or chest surgery (i.e. chest tube, PDA ligation, surgical NEC)
• Congenital malformation of the chest of abdomen
• Neuromuscular disorder
• Current medications affecting neuromuscular tone (ex morphine)
• Unable to be positioned either prone or supine as determined by the attending neonatologist.