ArticleWorld journal of pediatrics : WJP2025
Impact of lateral positioning on upper airway morphology in sedated children under five.
Article in World journal of pediatrics : WJP, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Corrective steps during neonatal mask ventilation - a narrative review of the evidence behind the MR SOPA acronym.Resuscitation plus · 2026Review
- The efficacy and safety of fiberoptic bronchoscopy-guided bronchial alveolar lavage combined with local drug injection in the treatment of severe pneumonia: a systematic review and meta-analysis based on randomized controlled trials.Journal of thoracic disease · 2026Article
- Case Report: Awake lateral decubitus intubation for a patient with critical tracheal stenosis secondary to retrosternal goiter: salvaging a 2 mm airway without ECMO support.Frontiers in oncology · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
backgroundThe upper airway morphology in children varies with age and body position. This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under five.
methodsThis retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children's Hospital, Zhejiang University School of Medicine. Upper airway morphology was reconstructed using 3D Slicer software. Python was employed to estimate cross-sectional areas via pixel analysis. The narrowest cross-sectional area, minimal transverse and anteroposterior diameters, airway length, and airway volume were measured and stratified by age for subgroup analysis.
resultsIn sedated children under 5 years old and when compared to the supine position, lateral positioning increased minimal transverse diameter by 18.70% (P = 0.001), narrowest cross-sectional area by 49.21% (P < 0.001), anteroposterior diameter by 25.54% (P < 0.001), airway volume by 65.64% (P < 0.001), and airway length by 11.93% (P < 0.001). In all subgroups, lateral positioning significantly increased the narrowest cross-sectional area, airway length, and airway volume. However, minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3 -to 5-year age group tended to increase in the lateral position but did not reach statistical significance.
conclusionsLateral position significantly enlarges the upper airway in sedated children under five. These findings support using lateral position to enhance airway patency in younger patients.
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