Comparing the effects of minimal handling protocols on the physiological parameters of preterm infants receiving exogenous surfactant therapy

Abstract

BackgroundThe practice of minimal handling is recommended for preterm infants (PTIs). However, few studies have investigated the effects of this practice among these infants or the time needed to ensure greater physiological stability, especially after exogenous surfactant treatments. Objective The current study compared the effects of two protocols of minimal handling on the physiological variables of PTIs after surfactant therapy. Method An exploratory prospective observational study was performed with 40 PTIs weighing less than 1,500 g. The infants were divided into two groups and monitored for 72 hours. One group received the standard minimal handling procedure during the first 12 hours after surfactant therapy; the other group (i.e., the modified group) received minimal handling within 72 hours after surfactant therapy. Infant heart rate (HR), oxygen saturation, body temperature, and the adverse events associated with changes to these variables were monitored every 10 minutes. Results Significant between-group differences were not found with regard to the occurrence of the adverse events associated with physiological changes (p>0.05). Conclusion The practice of minimal handling among very low birth weight infants did not alter their physiological stability when performed either 12 or 72 hours after surfactant therapy.

Effects of Hammock Positioning on Clinical Parameters in Preterm Infants Admitted to a Neonatal Intensive Care Unit: A Systematic Review

“…26 Furthermore, the routine procedures and painful stimuli within the unit increasingly corroborate the need for minimal handling of these patients. 27 Non-pharmacological and low-risk resources that promote the reduction of stress and pain levels in PTNB should be encouraged, such as hammock positioning. 4 In this review, three studies 8,14,23 reported that such intervention generated a reduction in pain levels, by using different assessment tools.…”

Single-centre prospective observational study on postdelivery room care

“…Studies suggest that developmental care routines such as maximising rest periods improve developmental outcome and support the autonomic stability and selfregulation abilities of preterm infants. 5 A solution may be to postpone non-mandatory interventions such as measurement of length and head circumference and to perform necessary interventions as quickly as possible without any interruptions.…”

“…One of the focuses was on different duration of time periods identified within the post-DR care because maximising rest periods has been shown to improve developmental outcome of preterm infants. 5 A second focus was on disconnections from the ventilator because in a study on piglets with acute respiratory distress, those resulted in a time-dependent decruitment of lung regions. 6 The third focus was on positioning of preterm infants during post-DR care because studies imply that this might be of relevance for preterm infants recovering from respiratory disease.…”