Physiological stress responses in infants at 29-32 weeks' postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments.
Physiological stress responses in infants at 29-32 weeks' postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments.
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DOI：
10.1136/bmjpo-2017-000025
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发表时间：
2017
影响因子：
2.6
通讯作者：
Spittle AJ
中科院分区：
文献类型：
--
作者：
Allinson LG;Denehy L;Doyle LW;Eeles AL;Dawson JA;Lee KJ;Spittle AJ
比较胎龄<30周的婴儿在接受集中护理时的生理应激反应与新生儿托儿所的标准化神经行为评估。从三级新生儿重症监护室招募了34名出生时妊娠<30周的婴儿。在集群护理和标准化神经行为评估（包括一般运动评估、Hammersmith新生儿神经系统检查和Premie-Neuro评估）期间记录心率（HR）和血氧饱和度。两名评估员以5秒间隔提取HR和氧饱和度，HR不稳定定义为心动过速（HR >180次/分钟（bpm））或心动过缓（HR <100 bpm）。血氧饱和度下降定义为SpO 2 <90%。生理稳定性之间进行了比较护理和神经行为评估使用线性（连续的结果）和逻辑（HR不稳定性和氧饱和度下降）回归。与集群护理相比，在标准化神经行为评估期间，HR较低（平均差异-5.9 bpm; 95% CI-6.5至5.3; P<0.001），血氧饱和度较高（平均差异2.4%; 95% CI 2.1%至2.6%; P<0.001）。与集群护理相比，神经行为评估也与心动过速（OR 0.44，95% CI 0.22至0.86）、HR不稳定（OR 0.43，95% CI 0.22至0.85）和氧饱和度下降（OR 0.43，95% CI 0.26至0.70）的几率降低相关。标准化的神经行为评估与29-32周经后年龄的婴儿的集群护理相比，与更少的生理压力相关，因此可能不会对医学上稳定的婴儿造成过度的生理干扰。
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. 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. 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). 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.
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影响因子：
2.5
作者：
Holsti, L;Grunau, RE;Whitfield, MF
通讯作者：
Whitfield, MF
影响因子：
2.4
作者：
Spittle AJ;Thompson DK;Brown NC;Treyvaud K;Cheong JL;Lee KJ;Pace CC;Olsen J;Allinson LG;Morgan AT;Seal M;Eeles A;Judd F;Doyle LW;Anderson PJ
通讯作者：
Anderson PJ
DOI：
10.1177/0884217503255009
发表时间：
2003-07-01
影响因子：
1.8
作者：
Bremmer, P;Byers, JF;Kiehl, E
通讯作者：
Kiehl, E
影响因子：
7.4
作者：
CRAIG, KD;WHITFIELD, MF;HADJISTAVROPOULOS, HD
通讯作者：
HADJISTAVROPOULOS, HD
影响因子：
1.3
作者：
Johnson, AN
通讯作者：
Johnson, AN