Preterm infants’ behaviors and skin conductance responses to nurse handling in the NICU

Zeiner, Veronika; Storm, Hanne; Doheny, Kim K.

doi:10.3109/14767058.2015.1092959

Cited by 23 publications

(22 citation statements)

References 31 publications

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“…With sympathetic activation, there are quantifiable increases in the number and amplitude of electrodermal or skin conductance responses. The use of SC has been well documented in term and preterm infants with conditions associated with pain, stress and arousal . SC also has been demonstrated to be a better measure of SNS activation than heart rate or blood pressure, because it is not affected by hemodynamic variability .…”

Section: Introductionmentioning

confidence: 99%

Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal

et al. 2015

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Aim Skin conductance (SC) provides an objective measure of autonomic system regulation through sympathetic-mediated filling of sweat glands. This study aimed to test the utility of SC to detect sympathetic activation in neonatal abstinence syndrome (NAS). Methods 14 term (mean, SE: 38.8 ± 0.35 weeks gestational age) neonates with chronic prenatal opiate exposure were enrolled. SC (peaks/sec and mean of peaks) were measured at baseline, during heel lance/squeeze (HLS) and recovery from HLS at 24-48 (mean 38) hours of life prior to treatment for NAS. Blinded coders with established reliability assessed neonates using the Modified Finnegan Neonatal Scoring System (MFNSS). Non-parametric tests were used to determine group differences, phase differences from baseline to HLS and HLS to recovery, and associations between MFNSS and SC measures. Results Neonates that would later require morphine treatment for NAS (n = 6) had higher baseline SC mean of peaks than those that did not require treatment (n = 8) (P<0.05). Moreover, there were unique phase differences between groups and SC positively correlated with MFNSS (P< 0.05). Conclusion SC provides early identification of NAS severity. However, a larger sample is needed to determine sensitivity and specificity of SC for early identification of NAS and treatment effectiveness.

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Section: Introductionmentioning

confidence: 99%

Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal

et al. 2015

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“…Despite these efforts, preterm infants in the NICU, often still receive schedulebased caregiving. Recently, Zeiner, Storm, and Kopenhaver Doheny [15] found that heart rate, respiratory rate, skin conductance frequency, and infant stress behaviors all significantly increased during nurse caregiving sessions with preterm infants.…”

Section: Discussionmentioning

confidence: 99%

“…When an intentional introduction was performed, a marked decrease in heart rate and increase in oxygen saturation after care, hints at an improved capacity for recovery after stressful events occurring during care. Heart rate and oxygen saturation are indicators of stress reactivity in preterm infants [15] and infants under three months have demonstrated an elevation in cortisol levels during routine handling. [20] Additionally, a positive relationship between regulatory and dysregulatory behavior frequency during care suggests that regulatory behaviors may, in fact, not represent regulation but the infant's attempt to return to a regulated state given the experience of stress or dysregulation.…”

Section: Discussionmentioning

confidence: 99%

Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

Gonya

Niski²,

Cistone³

2018

JNEP

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The neonatal intensive care unit (NICU) is, inherently, a trauma environment for the extremely premature infant. This trauma is often exacerbated by nurse caregiving practices that can be modified and still remain effective. Our study explored how behavior analytics could be used to implement an intervention known as Care by Cues and how the intervention might, ultimately, impact infant physiologic stability.

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“…Preterm infants in the NICU are exposed to numerous acute and chronic stressors throughout their hospitalization, including physiologic stressors (e.g., sepsis), experiential stressors (e.g., lab draws), and environmental stressors (e.g., excessive light, excessive noise) (Newn- | 63 review found that infants admitted to the NICU experience an average of 7.5-17.3 painful procedures per day and that lower gestational age at birth predicts a higher number of procedures (Cruz, Fernandes, & Oliveira, 2016). Research evidence reveals that environmental conditions and seemingly innocuous procedures, such as diaper changes and repositioning, can elicit stress responses in preterm infants (Peng et al, 2009;Zeiner, Storm, & Doheny, 2016).…”

Section: Neonatal Stress Exposurementioning

confidence: 99%

The biological embedding of neonatal stress exposure: A conceptual model describing the mechanisms of stress‐induced neurodevelopmental impairment in preterm infants

Nist

Harrison

Steward

2018

Research in Nursing & Health

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The biological embedding of early life stress exposure may result in life‐long neurodevelopmental impairment in preterm infants. Infants hospitalized in the neonatal intensive care unit are exposed to significant experiential, environmental, and physiologic stressors over the course of their extended hospitalization. Stress exposure during the sensitive period of brain development may alter biological processes, including functioning of the immune system, the autonomic nervous system, and the hypothalamic‐pituitary‐adrenal axis as well as gene expression. These alterations may subsequently affect brain structure and function. Changes to these processes may mediate the relationship between neonatal stress exposure and neurodevelopment in preterm infants and represent potential therapeutic targets to improve long‐term outcomes. The purpose of this paper is to introduce a conceptual model, based on published research, that describes the mechanisms mediating stress exposure and neurodevelopment impairment in preterm infants and to provide the theoretical foundation on which to base future descriptive research, intervention studies, and clinical care.

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Preterm infants’ behaviors and skin conductance responses to nurse handling in the NICU

Cited by 23 publications

References 31 publications

Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal

Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal

Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

The biological embedding of neonatal stress exposure: A conceptual model describing the mechanisms of stress‐induced neurodevelopmental impairment in preterm infants

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