Preterm infants' behavioural indicators of oxygen decline during bottle feeding
Preterm infants' behavioural indicators of oxygen decline during bottle feeding
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DOI：
10.1046/j.1365-2648.2003.02762.x
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发表时间：
2003-09-01
影响因子：
3.8
通讯作者：
Carlson, JR
中科院分区：
文献类型：
--
作者：
Thoyre, SM;Carlson, JR
背景。在早产儿经口喂养技能发展的过程中，他们经常会经历生理不稳定，需要护理人员的帮助以维持足够的氧合。帮助婴儿在经口喂养期间保持最佳氧合需要了解他们的表达方式并旨在自我调节氧气状态。目标。本研究的目的是确定早产儿早期奶瓶喂养期间氧合下降的潜在行为指标。该设计具有探索性。数据收集自对 20 段早产儿奶瓶喂养录像的二次分析，其中包括同时发生的氧饱和度数据。在这项分析中，对婴儿的行为和呼吸质量进行了编码并在三个时期进行了比较：高氧饱和度、氧饱和度降低事件之前以及氧饱和度降低事件期间。婴儿给出的氧合作用下降的行为指标有限。在发生去饱和事件之前，他们的眼球扑动增加，并且通常出现吸吮和呼吸暂停的情况。在去饱和事件期间，他们通常放松手臂/手并停止吸吮。结论。对早产儿行为线索的依赖不足以检测口服喂养期间的氧饱和度下降。注意呼吸音的变化和吸吮模式是预防喂养期间氧气下降并对其做出适当反应的潜在重要干预策略。吸吮暂停可能是早产儿调节呼吸模式从而增加氧合的时间。以油检测和喂养期间呼吸暂停最小化为重点的干预措施，旨在保护婴儿吸吮暂停，可以减少早产儿在奶瓶喂养期间经历的去饱和事件的数量和严重程度。
Background. During the time when preterm infants' oral feeding skills are developing they often experience physiological instability and need assistance from caregivers to maintain adequate oxygenation. Assisting infants to maintain optimal oxygenation during oral feeding requires an understanding of how they express and aim to self-regulate their oxygen status.Aim. The purpose of this study was to identify potential behavioural indicators of declining oxygenation during preterm infant early bottle-feeding.Method. The design was explorative. Data were collected from a secondary analysis of 20 videotapes of preterm infant bottle feedings which included concurrent oxygen saturation data. In this analysis infant behaviours and quality of breathing were coded and compared across three periods: high oxygen saturation, immediately preceding an oxygen desaturation event, and during an oxygen desaturation event.Findings. Infants gave limited behavioural indicators of declining oxygenation. Immediately prior to a desaturation event, they had an increase in eye flutter and were typically sucking and apnoeic. During a desaturation event, they typically relaxed their arms/hands and stopped sucking.Conclusions. Reliance on preterm infant behavioural cues will be insufficient for detection of oxygen desaturation during oral feeding. Attention to changes in breath sounds and to the pattern of sucking are potentially important intervention strategies for the prevention of and appropriate response to oxygen decline during feeding. Sucking pauses may be a time when preterm infants aim to regulate their breathing pattern and thereby increase oxygenation. Interventions that focus oil detection and minimization of apnoea during feeding, and which aim to protect infant sucking pauses, may reduce the number and severity of desaturation events preterm infants experience during bottle feeding.