Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study.
Kangaroo Care modifies preterm infant heart rate variability in response to heel stick pain: pilot study.
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DOI：
10.1016/j.earlhumdev.2009.05.012
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发表时间：
2009-09
影响因子：
2.5
通讯作者：
Fu, Pingfu
中科院分区：
文献类型：
--
作者：
Cong, Xiaomei;Ludington-Hoe, Susan M.;McCain, Gail;Fu, Pingfu
脚后跟贴是新生儿重症监护病房中早产儿最常见的痛苦程序。由此产生的疼痛会对主要器官系统造成不利的生理影响。袋鼠护理(KC)，包括母婴皮肤接触，是一种很有前途的婴儿疼痛止痛剂；然而，KC对自主神经系统对疼痛的反应的影响尚不清楚。为了确定KC是否比标准方法(婴儿仍留在保温箱中)对脚后跟贴痛的自主神经反应的平衡性得到改善。一项随机交叉试验。早产儿14例，胎龄30-32周，出生后不到9天。婴儿的行为状态、心率、心率变异性(HRV)指标包括低频(LF)和高频(HF)功率，以及在KC和IC条件下测量的LF/HF比率、高跟鞋保暖、高跟棒和恢复期。KC组和IC组的HRV差异是：KC组基线(p<；.01)和高跟棒组(p<；.001)的LF高于IC组(p<；.001)，KC组基线时的HF高于IC组(p<；.05)。在不同时期，KC组的LF/HF比值波动小于IC组，且在恢复期KC组显著低于IC组(p<；.001)。婴儿在KC状态下的反应比IC状态下有更好的平衡性，这表现为在脚后跟固定时的自主神经稳定性更高。KC可能有助于调节早产儿对痛苦手术的生理反应。
Heel stick is the most common painful procedure for preterm infants in neonatal intensive care units. Resultant pain causes adverse physiological effects in major organ systems. Kangaroo Care (KC), involving mother-infant skin-to-skin contact is a promising analgesic for infant pain; however, the effect of KC on the autonomic nervous system's response to pain is unknown. To determine if KC results in improved balance in autonomic responses to heel stick pain than the standard method where infants remain in an incubator care (IC) for the heel stick. A randomized cross-over trial. Fourteen preterm infants, 30-32 weeks gestational age and less than 9 days postnatal age. Infant behavioral state, heart rate, heart rate variability (HRV) indices including low frequency (LF) and high frequency (HF) power, and the LF/HF ratio measured over Baseline, Heel Warming, Heel Stick, and Recovery periods in KC and IC conditions. HRV differences between KC and IC were that LF was higher in KC at Baseline (p<.01) and at Heel Stick (p< .001), and HF was higher in KC at Baseline than in the IC condition (p< .05). The LF/HF ratio had less fluctuation across the periods in KC than in IC condition and was significantly lower during Recovery in KC than in IC (p< .001). Infants experienced better balance in response in KC than IC condition as shown by more autonomic stability during heel stick. KC may be helpful in mediating physiologic response to painful procedures in preterm infants.
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