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Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments
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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842990/ https://www.ncbi.nlm.nih.gov/pubmed/29637097 http://dx.doi.org/10.1136/bmjpo-2017-000025 |
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author | Allinson, Leesa G Denehy, Linda Doyle, Lex W Eeles, Abbey L Dawson, Jennifer A Lee, Katherine J Spittle, Alicia J |
author_facet | Allinson, Leesa G Denehy, Linda Doyle, Lex W Eeles, Abbey L Dawson, Jennifer A Lee, Katherine J Spittle, Alicia J |
author_sort | Allinson, Leesa G |
collection | PubMed |
description | 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 SpO(2)<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. |
format | Online Article Text |
id | pubmed-5842990 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-58429902018-04-10 Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments Allinson, Leesa G Denehy, Linda Doyle, Lex W Eeles, Abbey L Dawson, Jennifer A Lee, Katherine J Spittle, Alicia J BMJ Paediatr Open Original Article 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 SpO(2)<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. BMJ Publishing Group 2017-11-25 /pmc/articles/PMC5842990/ /pubmed/29637097 http://dx.doi.org/10.1136/bmjpo-2017-000025 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Original Article Allinson, Leesa G Denehy, Linda Doyle, Lex W Eeles, Abbey L Dawson, Jennifer A Lee, Katherine J Spittle, Alicia J Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title | Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title_full | Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title_fullStr | Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title_full_unstemmed | Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title_short | Physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
title_sort | physiological stress responses in infants at 29–32 weeks’ postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842990/ https://www.ncbi.nlm.nih.gov/pubmed/29637097 http://dx.doi.org/10.1136/bmjpo-2017-000025 |
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