Impact of hands-on care on infant sleep in the neonatal intensive care unit.
Impact of hands-on care on infant sleep in the neonatal intensive care unit.
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DOI：
10.1002/ppul.23513
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发表时间：
2017-01
影响因子：
3.1
通讯作者：
Shellhaas RA
中科院分区：
文献类型：
--
作者：
Levy J;Hassan F;Plegue MA;Sokoloff MD;Kushwaha JS;Chervin RD;Barks JD;Shellhaas RA
睡眠中断在住院患者中越来越多。睡眠受损与神经发育的可测量变化有关。新生儿重症监护室（NICU）环境有可能影响睡眠质量和数量。我们的目标是：（i）确定NICU患者动手护理的频率和持续时间及其对睡眠的影响;（ii）评估与处理一组患病新生儿相关的呼吸事件的发生率。由于疾病严重程度或临床怀疑癫痫发作而进入NICU并有脑功能障碍风险的足月和近足月新生儿接受了护理床旁多导睡眠图检查。分析连续多导睡眠图片段，记录处理、婴儿行为状态和相关呼吸事件的数据。对25名婴儿（胎龄39.4 ± 1.6周）的视频和多导睡眠图数据进行了评估。每名婴儿处理事件之间的最长持续时间为50.9 ± 26.2分钟，接触之间的中位数为2.3分钟。处理发生在所有行为状态中（活跃睡眠29.5%;安静睡眠23.1%;清醒29.9%;不确定17.4%; P = 0.99）。57%的婴儿在与熟睡的婴儿接触时会被唤醒或唤醒。分别有16%、8%和19.5%的接触者发生呼吸不足、呼吸暂停和氧饱和度下降。与处于活跃睡眠状态的婴儿接触后最易发生呼吸不足（28%; P < 0.001）。新生儿重症监护室的婴儿经历频繁的动手护理，与睡眠和呼吸障碍有关。这些干扰的潜在健康和发育影响值得研究，因为监测睡眠和尽量减少睡眠呼吸障碍的策略可能会改善NICU的结果。
Sleep disruption is increasingly recognized in hospitalized patients. Impaired sleep is associated with measureable alterations in neurodevelopment. The neonatal intensive care unit (NICU) environment has the potential to affect sleep quality and quantity. We aimed: (i) to determine the frequency and duration of hands-on care, and its impact on sleep, for NICU patients; and (ii) to assess the incidence of respiratory events associated with handling for a cohort of sick neonates. Term and near-term neonates admitted to the NICU and at risk for cerebral dysfunction due to severity of illness or clinical suspicion for seizures underwent attended, bedside polysomnography. Continuous polysomnogram segments were analyzed and data on handling, infant behavioral state, and associated respiratory events were recorded. Video and polysomnography data were evaluated for 25 infants (gestational age 39.4 ± 1.6 weeks). The maximum duration between handling episodes for each infant was 50.9 ± 26.2 min, with a median of 2.3 min between contacts. Handling occurred across all behavioral states (active sleep 29.5%; quiet sleep 23.1%; awake 29.9%; indeterminate 17.4%; P = 0.99). Arousals or awakenings occurred in 57% of contacts with a sleeping infant. Hypopnea, apnea, and oxygen desaturation occurred with 16%, 8%, and 19.5% of contacts, respectively. Hypopnea was most likely to occur following contact with infants in active sleep (28%; P < 0.001). Infants in the NICU experience frequent hands-on care, associated with disturbances of sleep and respiration. The potential health and developmental impact of these disturbances merits study, as strategies to monitor sleep and minimize sleep-disordered breathing might then improve NICU outcomes.
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DOI：
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发表时间：
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期刊：
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影响因子：
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