RT Journal Article
SR Electronic
T1 Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments
JF BMJ Paediatrics Open
FD BMJ Publishing Group Ltd
SP e000025
DO 10.1136/bmjpo-2017-000025
VO 1
IS 1
A1 Leesa G Allinson
A1 Linda Denehy
A1 Lex W Doyle
A1 Abbey L Eeles
A1 Jennifer A Dawson
A1 Katherine J Lee
A1 Alicia J Spittle
YR 2017
UL http://bmjpaedsopen.bmj.com/content/1/1/e000025.abstract
AB Objective To compare the physiological stress responses of infants born <30 weeks’ gestational age when undergoing clustered nursing cares with standardised neurobehavioural assessments in neonatal nurseries.Design/methods Thirty-four infants born <30 weeks’ gestation were recruited from a tertiary neonatal intensive care unit. Heart rate (HR) and oxygen saturation were recorded during clustered nursing cares and during standardised neurobehavioural assessments (including the General Movements Assessment, Hammersmith Neonatal Neurological Examination and Premie-Neuro Assessment). Two assessors extracted HR and oxygen saturations at 5 s intervals, with HR instability defined either as tachycardia (HR >180 beats per minute (bpm)) or bradycardia (HR <100 bpm). Oxygen desaturations were defined as SpO2<90%. Physiological stability was compared between nursing cares and neurobehavioural assessments using linear (for continuous outcomes) and logistic (HR instability and oxygen desaturation) regression.Results Compared with clustered nursing cares HR was lower (mean difference −5.9 bpm; 95% CI −6.5 to 5.3; P<0.001) and oxygen saturation higher (mean difference 2.4%; 95% CI 2.1% to 2.6%; P<0.001) during standardised neurobehavioural assessments. Compared with clustered nursing cares neurobehavioural assessments were also associated with reduced odds of tachycardia (OR 0.44, 95% CI 0.22 to 0.86), HR instability (OR 0.43, 95% CI 0.22 to 0.85) and oxygen desaturation (OR 0.43, 95% CI 0.26 to 0.70).Conclusions Standardised neurobehavioural assessments are associated with less physiological stress than clustered nursing cares in infants aged 29–32 weeks’ postmenstrual age, and are therefore possible without causing undue physiological disturbance in medically stable infants.