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Odebrecht Vergne de Abreu AC, Alves Braga de Oliveira M, Alquati T, Tonon AC, de Novaes Reis M, Camargo Rossi A, Sbaraini Bonatto F, Paz Hidalgo M. Use of Light Protection Equipment at Night Reduces Time Until Discharge From the Neonatal Intensive Care Unit: A Randomized Interventional Study. J Biol Rhythms 2024; 39:68-78. [PMID: 37846856 DOI: 10.1177/07487304231201752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Newborn infants' circadian systems are not completely developed and rely on external temporal cues for synchronizing their biological rhythms to the environment. In neonatal intensive care units (NICUs), lighting is usually continuous or irregular and infants are exposed to artificial light at night, which can have negative health consequences. Therefore, the aim of this study was to evaluate the impact of the use of individual light protection equipment at night on the development and growth of preterm neonates. Infants born at less than 37 gestational weeks who no longer needed constant intensive care were admitted into a newborn nursery and randomized to either use eye masks at night (intervention, n = 21) or not (control, n = 20). Infants who used eye protection at night were discharged earlier than those in the control group (8 [5] vs 12 [3.75] days; p < 0.05). A greater variation within the day in heart rate was observed in the intervention group, with lower values of beats per minute at 1400 and 2000 h. There was no significant difference in weight gain between groups. In view of our results and of previous findings present in the literature, we suggest that combining a darkened environment at night with individual light protection devices creates better conditions for the development of preterm infants in the NICU. In addition, eye masks are an affordable and simple-to-use tool that can reduce hospitalization costs by decreasing the number of days spent in the NICU.
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Affiliation(s)
- Ana Carolina Odebrecht Vergne de Abreu
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Melissa Alves Braga de Oliveira
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Tamila Alquati
- Neonatology Department, Hospital Nossa Senhora de Pompéia, Caxias do Sul, RS, Brazil
| | - André Comiran Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mariana de Novaes Reis
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Augusto Camargo Rossi
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fernanda Sbaraini Bonatto
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Shykhveisi F, Jafarian Amiri R, Zabihi A, Haghshenas Mojaveri M, Arzani A, Chehrazi M, Chari ZV. Effect of eye shield and ear muffs on pain intensity during venous blood sampling in premature infants: a clinical trial study. BMC Pediatr 2023; 23:161. [PMID: 37024882 PMCID: PMC10077640 DOI: 10.1186/s12887-023-03978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Today, due to the side effects of drugs, there is a greater desire to use non-pharmacological interventions to relieve pain caused by painful procedures. Using non-pharmacological interventions in combination is more effective than using them alone in relieving the pain of infants. Reducing sensory and environmental stimuli such as visual and auditory stimuli is one of the non-pharmacological methods to relieve pain. The aim of this study was to investigate the effect of using eye shield and ear muffs on pain intensity during venous blood sampling of premature infants. METHODS In this clinical trial study, 148 premature neonates admitted to the Neonatal Intensive Care Unit of Rouhani and Children Hospitals in Babol were randomly assigned to four groups of 37. Fifteen minutes before intravenous blood sampling until 15 min later, in the first group, eye shield; in the second group, ear muffs, and in the third group, eye shield plus ear muffs were used. In the fourth group (control), blood sampling was performed routinely. NIPS pain scale and demographic questionnaire were used to collect the data. RESULTS The results showed that during the venous blood sampling was a significant difference between the mean pain intensity of neonatal in the eye shield plus ear muffs group (3.14 ± 0.71), the ear muffs group (4.43 ± 1.21), the eye shield group (5.41 ± 1.04).) and the control group (5.94 ± 0.84) (P = 0.001). Moreover, after the venous blood sampling, there was a significant difference between the mean neonatal pain intensity in the eye shield plus ear muffs group (1.19 ± 0.39), the ear muffs group (1.43 ± 0.50), the eye shield group (1.33 ± 0.37) and the control group (1.89 ± 0.90) (P = 0.001). CONCLUSIONS In this study, the pain severity during and after venous blood sampling in the ear muffs plus eye shield was lower than in other groups. Therefore, a combination of ear muffs and eye shield is recommended as a better pain reliever when performing venous blood sampling in premature infants.
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Affiliation(s)
- Fatemeh Shykhveisi
- Fatemeh Shykhveisi (MSc), Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Roghayeh Jafarian Amiri
- Department of Medical & Surgical Nursing, School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Ali Zabihi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Mohsen Haghshenas Mojaveri
- Department of Pediatrics, School of Medicine, Non-Communicable Pediatric Disease Research Center Health Research Institute Amirkola Hospital Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Arzani
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Epidemiology and Biostatistics, School of Health, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Valizadeh Chari
- Clinical Research Development Unit of Rouhani Hospital, Zahra Valizadeh Chari (BS), Babol University of Medical Sciences, Babol, Iran
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Cerritelli F, Frasch MG, Antonelli MC, Viglione C, Vecchi S, Chiera M, Manzotti A. A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows. Front Neurosci 2021; 15:721605. [PMID: 34616274 PMCID: PMC8488382 DOI: 10.3389/fnins.2021.721605] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022] Open
Abstract
The autonomic nervous system (ANS) is one of the main biological systems that regulates the body's physiology. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible "critical windows" that could impact its maturation. These "critical windows" could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors-i.e., fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure-may have an impact on the development of the vagus during the above-mentioned "critical window" and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses. In fact, fHRV is a non-invasive marker whose changes have been associated with ANS development, vagal modulation, systemic and neurological inflammatory reactions, and even fetal distress during labor.
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Affiliation(s)
- Francesco Cerritelli
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Martin G. Frasch
- Department of Obstetrics and Gynecology and Center on Human Development and Disability, University of Washington, Seattle, WA, United States
| | - Marta C. Antonelli
- Facultad de Medicina, Instituto de Biología Celular y Neurociencia “Prof. E. De Robertis”, Universidad de Buenos Aires, Buenos Aires, Argentina
- Department of Obstetrics and Gynecology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Chiara Viglione
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Stefano Vecchi
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Marco Chiera
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Andrea Manzotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
- Department of Pediatrics, Division of Neonatology, “V. Buzzi” Children's Hospital, Azienda Socio-Sanitaria Territoriale Fatebenefratelli Sacco, Milan, Italy
- Research Department, Istituto Osteopatia Milano, Milan, Italy
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Chiera M, Cerritelli F, Casini A, Barsotti N, Boschiero D, Cavigioli F, Corti CG, Manzotti A. Heart Rate Variability in the Perinatal Period: A Critical and Conceptual Review. Front Neurosci 2020; 14:561186. [PMID: 33071738 PMCID: PMC7544983 DOI: 10.3389/fnins.2020.561186] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022] Open
Abstract
Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often time-consuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a non-invasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come. When continuously monitored, HRV could help assess the baby’s overall wellbeing and neurological development to detect stress-/pain-related behaviors or pathological conditions, such as respiratory distress syndrome and hyperbilirubinemia, to address when to perform procedures to reduce the baby’s stress/pain and interventions, such as therapeutic hypothermia, and to avoid severe complications, such as sepsis and necrotizing enterocolitis, thus reducing mortality. Based on literature and previous experiences, the first step to efficiently introduce HRV in the NICUs could consist in a monitoring system that uses photoplethysmography, which is low-cost and non-invasive, and displays one or a few metrics with good clinical utility. However, to fully harness HRV clinical potential and to greatly improve neonatal care, the monitoring systems will have to rely on modern bioinformatics (machine learning and artificial intelligence algorithms), which could easily integrate infant’s HRV metrics, vital signs, and especially past history, thus elaborating models capable to efficiently monitor and predict the infant’s clinical conditions. For this reason, hospitals and institutions will have to establish tight collaborations between the obstetric, neonatal, and pediatric departments: this way, healthcare would truly improve in every stage of the perinatal period (from conception to the first years of life), since information about patients’ health would flow freely among different professionals, and high-quality research could be performed integrating the data recorded in those departments.
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Affiliation(s)
- Marco Chiera
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Research Commission on Manual Therapies and Mind-Body Disciplines, Societ Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | - Francesco Cerritelli
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Alessandro Casini
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy
| | - Nicola Barsotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Research Commission on Manual Therapies and Mind-Body Disciplines, Societ Italiana di Psico Neuro Endocrino Immunologia, Rome, Italy
| | | | - Francesco Cavigioli
- Neonatal Intensive Care Unit, "V. Buzzi" Children's Hospital, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy
| | - Carla G Corti
- Pediatric Cardiology Unit-Pediatric Department, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy
| | - Andrea Manzotti
- Research and Assistance for Infants to Support Experience Lab, Foundation Center for Osteopathic Medicine Collaboration, Pescara, Italy.,Neonatal Intensive Care Unit, "V. Buzzi" Children's Hospital, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Milan, Italy.,Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
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Effects of Cycled Lighting Versus Continuous Near Darkness on Physiological Stability and Motor Activity Level in Preterm Infants. Adv Neonatal Care 2017; 17:282-291. [PMID: 27984231 DOI: 10.1097/anc.0000000000000372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preterm infants generally spend weeks in the neonatal intensive care unit where light intensity can fluctuate as well as be high, leading to physiological instability and increased motor activity in these infants. To date, 2 lighting control methods have been studied: cycled lighting and continuous near darkness. The most appropriate method of lighting is still unknown due to ambivalent results from the studies that have assessed these 2 interventions. OBJECTIVE To compare the effects of cycled lighting versus continuous near darkness on physiological stability and motor activity level in preterm infants born between 28 and 32 weeks of gestation. METHODS A randomized clinical trial was conducted to compare physiological stability and motor activity level in preterm infants assigned to cycled lighting or continuous near darkness. Thirty-eight participants were recruited and randomly assigned to one of the lighting conditions for 24 hours. Physiological stability was measured using the Stability of the Cardiorespiratory System in Premature Infants (SCRIP) score, the means, and the coefficient of variation of each physiological parameter measured. The level of motor activity was measured with an accelerometer. RESULTS There were no significant differences between the 2 groups with regard to physiological stability measured by the SCRIP score, means, and coefficient of variation as well as motor activity level. Participants in both groups were physiologically stable and their motor activity level was comparable. IMPLICATIONS FOR PRACTICE AND RESEARCH Neither cycled lighting nor continuous near darkness negatively impacted infant's physiologic stability and motor activity level. Further research is required to identify the most appropriate lighting control method for preterm infants born between 28 and 32 weeks of gestation.
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Aita M, Goulet C, Oberlander TF, Snider L, Johnston C. A randomized controlled trial of eye shields and earmuffs to reduce pain response of preterm infants. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jnn.2014.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Research Abstracts From the 2015 NANN Research Summit. Adv Neonatal Care 2015. [DOI: 10.1097/anc.0000000000000201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Light Reduction Capabilities of Homemade and Commercial Incubator Covers in NICU. ISRN NURSING 2013; 2013:502393. [PMID: 24286012 PMCID: PMC3830803 DOI: 10.1155/2013/502393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 08/10/2013] [Indexed: 11/27/2022]
Abstract
Reduction of high-risk neonates' exposure to aversive light stimulation is an important component of developmentally supportive care. In neonatal intensive care unit (NICU), usually light is reduced by reducing the room's light level or by using incubator covers. Many types of incubator covers are in use, including homemade and commercial covers. A comparative study was used to determine the light reducing capabilities of 19 homemade incubator covers, 2 commercial covers, and 1 receiving blanket. The covers were tested by covering and uncovering an incubator and an oxygen hood in the NICU during daytime and nighttime lightings. The light reducing capabilities value was determined for each cover using an Extech light dosimeter when the cover was placed over and removed from an oxyhood, and an incubator. The study showed that the light reducing capability of the commercial covers was 91.2%, the homemade covers capability was 72.1%, and the receiving blankets capability was 55.1%. A significant difference between the commercial and homemade covers was found (F = 452.50, P < 0.00). Commercial incubator covers are the most effective covers to achieve light reduction; homemade covers can be effective if made large enough so that they completely cover all sides of the incubator.
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Brooks E, Canal MM. Development of circadian rhythms: role of postnatal light environment. Neurosci Biobehav Rev 2013; 37:551-60. [PMID: 23454636 DOI: 10.1016/j.neubiorev.2013.02.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/31/2013] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
Mammals are born with an immature circadian system, which completes its development postnatally. Evidence suggests that the environment experienced by a newborn will impact and shape its development, which will have future consequences at the levels of circadian system function, circadian behaviour and physiology, and potentially, the animal's long-term health and welfare. Here we review the various stages in postnatal development of the circadian system, and discuss the data available on the long-term effects of early environment, in particular light environment, on the animal's brain, physiology and behaviour.
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Affiliation(s)
- Elisabeth Brooks
- University of Manchester, Faculty of Life Sciences, AV Hill Building, Oxford Road, Manchester M13 9PT, UK
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10
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Aita M, Johnston C, Goulet C, Oberlander TF, Snider L. Intervention minimizing preterm infants' exposure to NICU light and noise. Clin Nurs Res 2012; 22:337-58. [PMID: 23275433 DOI: 10.1177/1054773812469223] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Neonatal intensive care unit (NICU) light and noise may be stressful to preterm infants. This research evaluated the physiological stability of 54 infants born at 28- to 32-weeks' gestational age while wearing eye goggles and earmuffs for a 4-hour period in the NICU. Infants were recruited from four NICUs of university-affiliated hospitals and randomized to the intervention-control or control-intervention sequences. Heart rate (HR), heart rate variability (HRV), and oxygen saturation (O2 sat) were collected using the SomtéTM device. Confounding variables such as position and handling were assessed by videotaping infants during the study periods. Results indicated that infants had more stress responses while wearing eye goggles and earmuffs since maximum HR was found to be significantly higher and high-frequency power of HRV significantly lower during the intervention as compared with the control period. Therefore, this intervention is not recommended for the clinical practice.
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Affiliation(s)
- Marilyn Aita
- University of Montreal, Montreal, Quebec, Canada.
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11
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The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol 2007; 27 Suppl 2:S48-74. [PMID: 18034182 DOI: 10.1038/sj.jp.7211844] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To review the existing evidence used to identify potentially better care practices that support newborn brain development. STUDY DESIGN Literature review. RESULT Sixteen potentially better practices are identified and grouped into two operational clinical bundles based upon timing for recommended implementation. CONCLUSION Existing evidence supports the implementation of selected care practices that potentially may support newborn brain development.
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12
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Geyer J, Ellsbury D, Kleiber C, Litwiller D, Hinton A, Yankowitz J. An evidence-based multidisciplinary protocol for neonatal circumcision pain management. J Obstet Gynecol Neonatal Nurs 2002; 31:403-10. [PMID: 12146929 DOI: 10.1111/j.1552-6909.2002.tb00062.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Pain experienced in infancy may have effects later in life. Neonatal circumcision is a common painful procedure. In addition to dorsal penile nerve block, interventions that may have a role in minimizing pain and distress in neonatal circumcision include use of a sucrose pacifier, buffered lidocaine, small needles, acetaminophen, swaddling, and environmental modification. The evidence for each intervention is presented and evaluated. Implementation of a comprehensive evidence-based circumcision pain control standard of practice is discussed.
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Affiliation(s)
- Janet Geyer
- Children's Hospital of Iowa, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA.
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13
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Abstract
The lighting environment of the preterm baby is quite unlike that experienced at any other time of life. Physical and physiological factors control how much light reaches the retina of the preterm baby. With respect to the former, although many neonatal intensive care units are brightly and continuously lit, there is a trend to employ lower levels of illumination and to introduce cycling regimens. Physiological determinants of the retinal light dose include: eyelid opening and transmission, pupil diameter and the transmission characteristics of the ocular media. Early exposure to light does not significantly hasten or retard normal visual development, and it is not a factor in the development of retinopathy of prematurity. However, ambient neonatal intensive care unit illumination may be implicated in some of the more subtle visual pathway sequelae that cannot be attributed to other major complications of preterm birth including altered visual functions and arrested eye growth.
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Affiliation(s)
- A R Fielder
- Imperial College of Science, Technology and Medicine, Imperial College School of Medicine, London, UK.
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14
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Peters KL. Infant handling in the NICU: does developmental care make a difference? An evaluative review of the literature. J Perinat Neonatal Nurs 1999; 13:83-109. [PMID: 10818863 DOI: 10.1097/00005237-199912000-00008] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Infant handling and disruptions in the neonatal intensive care unit are environmental stressors over which nurses have the most control. Two of the major goals of developmental care are individualizing care by decreasing infant disruptions and handling by caregivers, and modulating or attenuating infant responses to the care they receive. However, it has yet to be established to what extent these goals have been achieved. This article will provide a comparative review of selected literature to ascertain what effect, if any, the introduction of developmental care has had on infant handling or disruption in the neonatal intensive care unit.
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Affiliation(s)
- K L Peters
- Perinatal Research Centre, University of Alberta, Edmonton, Canada
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15
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Lotas MJ, Walden M. Individualized developmental care for very low-birth-weight infants: a critical review. J Obstet Gynecol Neonatal Nurs 1996; 25:681-7. [PMID: 8912219 DOI: 10.1111/j.1552-6909.1996.tb01482.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Its proponents suggest that individualized developmental care is effective in reducing infant morbidity and length of hospital stay and improving neurodevelopmental outcomes. Although individual components of developmental care have been researched in more depth, few studies have examined a total developmental care protocol. This article critically examines the research base on individualized developmental care and discusses implications for clinical practice and future research.
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Affiliation(s)
- M J Lotas
- Emory University, School of Nursing, Atlanta, GA 30322, USA
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16
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Miller CL, White R, Whitman TL, O'Callaghan MF, Maxwell SE. The effects of cycled versus noncycled lighting on growth and development in preterm infants. Infant Behav Dev 1995. [DOI: 10.1016/0163-6383(95)90010-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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17
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DEVELOPMENTAL CARE OF LOW BIRTH WEIGHT INFANTS. Nurs Clin North Am 1993. [DOI: 10.1016/s0029-6465(22)02862-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lacy JB, Ohlsson A. Behavioral outcomes of environmental or care-giving hospital-based interventions for preterm infants: a critical overview. Acta Paediatr 1993; 82:408-15. [PMID: 8318812 DOI: 10.1111/j.1651-2227.1993.tb12709.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J B Lacy
- Department of Rehabilitation Services, Women's College Hospital, Toronto, Canada
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