Relationship between energy expenditure and stress behaviors of preterm infants in the neonatal intensive care unit

Lin, Hung Chih; Huang, Li Chi; Li, Tsai‐Chung; Chen, Chau Huei; Bachman, Jean A.; Peng, Niang-Huei

doi:10.1111/jspn.12087

Cited by 5 publications

(3 citation statements)

References 32 publications

(52 reference statements)

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“…Modifying care patterns can help to safeguard energy expenditure and prevent the undesired outcomes (Weintraub, Mimouni, & Dollberg, 2007). Interestingly, the finding of previous studies indicated that some preterm behaviors, such as grimace, sucking, diffusion squirm, fist, gape face, salute, and sneezing, are related to increased energy expenditure (Lin et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

The role of weighing‐bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

Bembich

Trappan

Galimberti

et al. 2020

Specialist Pediatric Nursing

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Purpose: In the neonatal intensive care unit, preterm infants are exposed to several stressful stimuli. Inappropriate stimulation led to high risk for short-and long-term neurocognitive disabilities. This study aimed to evaluate whether the sequence of execution of weighing/bathing nursing procedures and postmenstrual age (PMA) have any effect on preterm infants' stress responses. Design and Methods: Prospective cross-sectional study on a sample of 21 preterm infants. Responses to the procedures were assessed using an observational sheet based on Als's Synactive Theory of Development. Autonomic and motor responses were scored according to five-point Likert scales. The order of execution of weighing/bathing nursing procedures and PMA were documented. Effects of weighing/bathing execution sequence and PMA on autonomic and motor response scores were analyzed by linear multiple regression analysis.Results: The sequence of execution had a significant effect on the autonomic score during weighing (p = .035), evidencing more stress when weighing was executed first.A higher level of stress response on the autonomic score during both weighing (p = .015) and bathing (p = .018) procedure was independently associated with a lower infant PMA. Conclusions and Practice Implications:The real-time recognition of adaptive/maladaptive responses allows nurses to personalize their approach to preterm infants, taking into account PMA and adjusting the appropriate sequence of execution of weighing/bathing nursing procedures.

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Section: Discussionmentioning

confidence: 99%

The role of weighing‐bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

Bembich

Trappan

Galimberti

et al. 2020

Specialist Pediatric Nursing

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show abstract

“…However, it is currently unclear what it means when an infant does not mount a response to a noxious stimulus in any given modality . For example, infants can fail to respond behaviorally and it is not well understood whether this truly reflects a lack of pain experience or is driven by other reasons such as lethargy . It is possible that a lack of response across several modalities, which would lead to misclassification in our model, is because the infant does not find the stimulus painful.…”

Section: Discussionmentioning

confidence: 99%

“… 44 For example, infants can fail to respond behaviorally 25 and it is not well understood whether this truly reflects a lack of pain experience or is driven by other reasons such as lethargy. 44 , 45 It is possible that a lack of response across several modalities, which would lead to misclassification in our model, is because the infant does not find the stimulus painful. However, interpreting these data are complex and further research is warranted.…”

Section: Discussionmentioning

confidence: 99%

Multimodal pain assessment improves discrimination between noxious and non‐noxious stimuli in infants

Vaart

Duff

Raafat

et al. 2019

Paediatric and Neonatal Pain

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Infants in neonatal intensive care units frequently experience clinically necessary painful procedures, which elicit a range of behavioral, physiological, and neurophysiological responses. However, the measurement of pain in this population is a challenge and no gold standard exists. The aim of this study was to investigate how noxious‐evoked changes in facial expression, reflex withdrawal, brain activity, heart rate, and oxygen saturation are related and to examine their accuracy in discriminating between noxious and non‐noxious stimuli. In 109 infants who received a clinically required heel lance and a control non‐noxious stimulus, we investigated whether combining responses across each modality, or including multiple measures from within each modality improves our ability to discriminate the noxious and non‐noxious stimuli. A random forest algorithm was used to build data‐driven models to discriminate between the noxious and non‐noxious stimuli in a training set which were then validated in a test set of independent infants. Measures within each modality were highly correlated, while different modalities showed less association. The model combining information across all modalities had good discriminative ability (accuracy of 0.81 in identifying noxious and non‐noxious stimuli), which was higher than the discriminative power of the models built from individual modalities. This demonstrates the importance of including multiple modalities in the assessment of infant pain.

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Parenteral Nutrition for the High-Risk Neonate

Huff¹,

DENNE²

2024

Avery's Diseases of the Newborn

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Relationship between energy expenditure and stress behaviors of preterm infants in the neonatal intensive care unit

Abstract: The interventions for preterm infants should be flexible, according to the infant's stress behaviors and conditions of energy expenditure.

Cited by 5 publications

References 32 publications

The role of weighing‐bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

The role of weighing‐bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

Multimodal pain assessment improves discrimination between noxious and non‐noxious stimuli in infants

Parenteral Nutrition for the High-Risk Neonate

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