Aly 2008.

Methods	DESIGN: randomised parallel controlled trial Method of randomisation: not stated Infant’s position: supine or lateral alternant (left and right every 2 hours) Blinding to intervention: no Complete follow‐up: no; 19 randomised participants dropped out of the study because of early death (15) or early extubation (4); group is unclear Blinding to outcome measurement: simple for tracheal culture
Participants	SETTING: neonatal intensive care unit, University Children’s Hospital of Cairo, Egypt DATE OF SAMPLE COLLECTION: started in 2005 and completed in 13 months PARTICIPANTS Sample size analysed: 60 newborns tracheally intubated at postnatal age of 48 hours and receiving conventional mechanical ventilation for 5 days (from a study of 79, investigators discarded data from 15 because of death and from 5 because of early extubation) Gestational age at birth (weeks) (range, mean ± SD): 31.6 to 39.1; supine (35.4 ± 4.2), lateral (35.3 ± 3.3) Postnatal age (days): 0 to 2 Birth weight (grams) (mean ± SD): supine (2.2 ± 0.94), prone (2.07 ± 0.7) Study weight: not stated Associated conditions: none stated Exclusions: congenital sepsis or pneumonia or congenital anomalies; individuals who could not be maintained on mechanical ventilation for 5 full days
Interventions	INTERVENTIONS: lateral (alternating left or right every 2 hours) vs supine CO‐INTERVENTIONS: fewer episodes of self‐extubation and need for reintubation in the lateral group, but none stated
Outcomes	Outcomes of interest in this review: arterial PCO2 Ventilator parameters: FiO2 Outcomes not assessed in this review: culture of tracheal aspiration Ventilator parameters: PIP, PEEP, IMV Blood gas data: pH, HCO3 level Laboratory data: WBC and platelet count, haemoglobin level Self‐extubation and need for reintubation
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Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of randomisation not stated
Allocation concealment (selection bias)	Unclear risk	Method of allocation not stated
Blinding of outcome assessment (detection bias) All outcomes	Low risk
Incomplete outcome data (attrition bias) All outcomes	High risk	Number randomised in each group unclear, no ITT
Selective reporting (reporting bias)	Unclear risk	No prespecified primary outcomes, so unclear
Other bias	Unclear risk	Co‐interventions not stated