TY - JOUR
T1 - Tactile stimulation to stimulate spontaneous breathing during Stabilization of preterm infants at birth
T2 - A retrospective analysis
AU - Dekker, Janneke
AU - Martherus, Tessa
AU - Cramer, Sophie J.E.
AU - van Zanten, Henriette A.
AU - Hooper, Stuart B.
AU - te Pas, Arjan B.
PY - 2017/4/3
Y1 - 2017/4/3
N2 - Background and aims: Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth. Methods: Recordings of physiological parameters and videos of infants < 32 weeks gestational age were retrospectively analyzed. Details of tactile stimulation during the first 7 min after birth (timing, duration, type, and indication) were noted. Results: Stimulation was performed in 164/245 (67%) infants. The median (IQR) GA was 28 6/7 (27 2/7-30 1/7) weeks, birth weight 1,153 (880-1,385) g, Apgar score at 5 min was 8 (7-9), 140/245 (57%) infants were born after cesarean section, and 134/245 (55%) were male. There were no significant differences between the stimulated and the non-stimulated infants with regard to basic characteristics. In the stimulated infants, the first episode of stimulation was given at a median (IQR) of 114 (73-182) s after birth. Stimulation was repeated 3 (1-5) times, with a median (IQR) duration of 8 (4-16) s and a total duration of 32 (15-64) s. Modes of stimulation were: rubbing (68%) or flicking (2%) the soles of the feet, rubbing the back (12%), a combination (9%), or other (8%). In 67% of the stimulation episodes, a clear indication was noted (25% bradycardia, 57% apnea, 48% hypoxemia, 43% combination) and an effect was observed in 18% of these indicated stimulation episodes. A total effect of all stimulation episodes per infant remains unclear, but infants who did not receive stimulation were more often intubated in the delivery room (14/79 (18%) vs 12/164 (7%), p < 0.05). Conclusion: There was a large variation in the use of tactile stimulation in preterm infants during stabilization at birth. In most cases, there was an indication for stimulation, but only in a small proportion an effect could be observed.
AB - Background and aims: Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth. Methods: Recordings of physiological parameters and videos of infants < 32 weeks gestational age were retrospectively analyzed. Details of tactile stimulation during the first 7 min after birth (timing, duration, type, and indication) were noted. Results: Stimulation was performed in 164/245 (67%) infants. The median (IQR) GA was 28 6/7 (27 2/7-30 1/7) weeks, birth weight 1,153 (880-1,385) g, Apgar score at 5 min was 8 (7-9), 140/245 (57%) infants were born after cesarean section, and 134/245 (55%) were male. There were no significant differences between the stimulated and the non-stimulated infants with regard to basic characteristics. In the stimulated infants, the first episode of stimulation was given at a median (IQR) of 114 (73-182) s after birth. Stimulation was repeated 3 (1-5) times, with a median (IQR) duration of 8 (4-16) s and a total duration of 32 (15-64) s. Modes of stimulation were: rubbing (68%) or flicking (2%) the soles of the feet, rubbing the back (12%), a combination (9%), or other (8%). In 67% of the stimulation episodes, a clear indication was noted (25% bradycardia, 57% apnea, 48% hypoxemia, 43% combination) and an effect was observed in 18% of these indicated stimulation episodes. A total effect of all stimulation episodes per infant remains unclear, but infants who did not receive stimulation were more often intubated in the delivery room (14/79 (18%) vs 12/164 (7%), p < 0.05). Conclusion: There was a large variation in the use of tactile stimulation in preterm infants during stabilization at birth. In most cases, there was an indication for stimulation, but only in a small proportion an effect could be observed.
KW - Birth
KW - Breathing
KW - Preterm
KW - Stabilization
KW - Stimulation
KW - Tactile
UR - http://www.scopus.com/inward/record.url?scp=85032898460&partnerID=8YFLogxK
U2 - 10.3389/fped.2017.00061
DO - 10.3389/fped.2017.00061
M3 - Article
AN - SCOPUS:85032898460
SN - 2296-2360
VL - 5
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
M1 - 61
ER -