Does the Head Position Affect Neonatal Lateral Ventricular Volume?

Abstract

Objective: This study aimed to determine whether there are differences in the lateral ventricular volumes, measured by three-dimensional ultrasound (3D US) depending on the posture of the neonate (right and left lateral decubitus).

Study design: This was a prospective analysis of the lateral ventricular volumes of preterm neonates recruited from Victoria Hospital, London, Ontario (June 2018-November 2019). A total of 24 premature neonates were recruited. The first cohort of 18 unstable premature neonates were imaged with 3D US in their current sides providing 15 right-sided and 16 left-sided 3D US images. The neonates in the second cohort of six relatively stable infants were imaged after positioning in each lateral decubitus position for 30 minutes, resulting in 40 3D US images obtained from 20 posture change sessions. The images were segmented and the ventricle volumes in each lateral posture were compared with determine whether the posture of the head influenced the volume of the upper and lower ventricle.

Results: For the first cohort who did not have their posture changed, the mean of the right and left ventricle volumes were 23.81 ± 15.51 and 21.61 ± 16.19 cm³, respectively, for the 15 images obtained in a right lateral posture and 13.96 ± 8.69 and 14.92 ± 8.77 cm³, respectively, for the 16 images obtained in the left lateral posture. Similarly, for the second cohort who had their posture changed, the mean of right and left ventricle volumes were 20.92 ± 17.3 and 32.74 ± 32.33 cm³, respectively, after 30 minutes in the right lateral posture, and 21.25 ± 18.4 and 32.65 ± 31.58 cm³, respectively, after 30 minutes in the left lateral posture. Our results failed to show a statistically significant difference in ventricular volumes dependence on posture.

Conclusion: Head positioned to any lateral side for 30 minutes does not have any effect on the lateral ventricular volumes of neonates.

Key points: · Three-dimensional cranial ultrasound can measure neonatal ventricle volume.. · Ventricle volume in each lateral ventricle may be affected by posture of the neonate.. · The 30 minutes in any lateral posture is not sufficient to create volume difference in lateral ventricles..