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Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis
BACKGROUND AND AIMS: Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at b...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5377072/ https://www.ncbi.nlm.nih.gov/pubmed/28421171 http://dx.doi.org/10.3389/fped.2017.00061 |
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author | Dekker, Janneke Martherus, Tessa Cramer, Sophie J. E. van Zanten, Henriette A. Hooper, Stuart B. te Pas, Arjan B. |
author_facet | Dekker, Janneke Martherus, Tessa Cramer, Sophie J. E. van Zanten, Henriette A. Hooper, Stuart B. te Pas, Arjan B. |
author_sort | Dekker, Janneke |
collection | PubMed |
description | BACKGROUND AND AIMS: Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth. METHODS: Recordings of physiological parameters and videos of infants <32 weeks gestational age were retrospectively analyzed. Details of tactile stimulation during the first 7 min after birth (timing, duration, type, and indication) were noted. RESULTS: Stimulation was performed in 164/245 (67%) infants. The median (IQR) GA was 28 6/7 (27 2/7–30 1/7) weeks, birth weight 1,153 (880–1,385) g, Apgar score at 5 min was 8 (7–9), 140/245 (57%) infants were born after cesarean section, and 134/245 (55%) were male. There were no significant differences between the stimulated and the non-stimulated infants with regard to basic characteristics. In the stimulated infants, the first episode of stimulation was given at a median (IQR) of 114 (73–182) s after birth. Stimulation was repeated 3 (1–5) times, with a median (IQR) duration of 8 (4–16) s and a total duration of 32 (15–64) s. Modes of stimulation were: rubbing (68%) or flicking (2%) the soles of the feet, rubbing the back (12%), a combination (9%), or other (8%). In 67% of the stimulation episodes, a clear indication was noted (25% bradycardia, 57% apnea, 48% hypoxemia, 43% combination) and an effect was observed in 18% of these indicated stimulation episodes. A total effect of all stimulation episodes per infant remains unclear, but infants who did not receive stimulation were more often intubated in the delivery room (14/79 (18%) vs 12/164 (7%), p < 0.05). CONCLUSION: There was a large variation in the use of tactile stimulation in preterm infants during stabilization at birth. In most cases, there was an indication for stimulation, but only in a small proportion an effect could be observed. |
format | Online Article Text |
id | pubmed-5377072 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-53770722017-04-18 Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis Dekker, Janneke Martherus, Tessa Cramer, Sophie J. E. van Zanten, Henriette A. Hooper, Stuart B. te Pas, Arjan B. Front Pediatr Pediatrics BACKGROUND AND AIMS: Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth. METHODS: Recordings of physiological parameters and videos of infants <32 weeks gestational age were retrospectively analyzed. Details of tactile stimulation during the first 7 min after birth (timing, duration, type, and indication) were noted. RESULTS: Stimulation was performed in 164/245 (67%) infants. The median (IQR) GA was 28 6/7 (27 2/7–30 1/7) weeks, birth weight 1,153 (880–1,385) g, Apgar score at 5 min was 8 (7–9), 140/245 (57%) infants were born after cesarean section, and 134/245 (55%) were male. There were no significant differences between the stimulated and the non-stimulated infants with regard to basic characteristics. In the stimulated infants, the first episode of stimulation was given at a median (IQR) of 114 (73–182) s after birth. Stimulation was repeated 3 (1–5) times, with a median (IQR) duration of 8 (4–16) s and a total duration of 32 (15–64) s. Modes of stimulation were: rubbing (68%) or flicking (2%) the soles of the feet, rubbing the back (12%), a combination (9%), or other (8%). In 67% of the stimulation episodes, a clear indication was noted (25% bradycardia, 57% apnea, 48% hypoxemia, 43% combination) and an effect was observed in 18% of these indicated stimulation episodes. A total effect of all stimulation episodes per infant remains unclear, but infants who did not receive stimulation were more often intubated in the delivery room (14/79 (18%) vs 12/164 (7%), p < 0.05). CONCLUSION: There was a large variation in the use of tactile stimulation in preterm infants during stabilization at birth. In most cases, there was an indication for stimulation, but only in a small proportion an effect could be observed. Frontiers Media S.A. 2017-04-03 /pmc/articles/PMC5377072/ /pubmed/28421171 http://dx.doi.org/10.3389/fped.2017.00061 Text en Copyright © 2017 Dekker, Martherus, Cramer, van Zanten, Hooper and te Pas. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Dekker, Janneke Martherus, Tessa Cramer, Sophie J. E. van Zanten, Henriette A. Hooper, Stuart B. te Pas, Arjan B. Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title | Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title_full | Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title_fullStr | Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title_full_unstemmed | Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title_short | Tactile Stimulation to Stimulate Spontaneous Breathing during Stabilization of Preterm Infants at Birth: A Retrospective Analysis |
title_sort | tactile stimulation to stimulate spontaneous breathing during stabilization of preterm infants at birth: a retrospective analysis |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5377072/ https://www.ncbi.nlm.nih.gov/pubmed/28421171 http://dx.doi.org/10.3389/fped.2017.00061 |
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