Sound and vibration: effects on infants’ heart rate and heart rate variability during neonatal transport

Abstract

This is an accepted version of a paper published in Acta Paediatrica. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the published paper: Karlsson, B., Lindkvist, M., Lindkvist, M., Karlsson, M., Lundström, R. et al. (2012) "Sound and vibration: effects on infants' heart rate and heart rate variability during neonatal transport." Acta Paediatrica, 101(2): 148-154 URL: http://dx.doi.org/10.1111/j. 1651-2227.2011.02472.x Access to the published version may require subscription. ABSTRACTAim: To measure the effect of sound and whole-body vibration on infants' heart rate and heart rate variability during ground and air ambulance transport.Methods: Sixteen infants were transported by air ambulance with ground ambulance transport to and from the airports. Whole-body vibration and sound levels were recorded and heart parameters were obtained by ECG signal.Results: Sound and whole-body vibration levels exceeded the recommended limits. Mean whole-body vibration and sound levels were 0.19m/s 2 and 73dBA, respectively. Higher whole-body vibration was associated with a lower heart rate (p<0.05), and higher sound level was linked to a higher heart rate (p=0.05). The heart rate variability was significantly higher at the end of the transport than at the beginning (p<0.01). Poorer physiologic status was associated with lower heart rate variability (p<0.001) and a lower heart rate (p<0.01). Infants wearing earmuffs had a lower heart rate (p<0.05). Conclusions:Sound and whole-body vibration during neonatal transport exceed recommended levels for adults and sound seem to have a more stressful effect on the infant than vibrations. Infants should wear earmuffs during neonatal transport because of the stress reducing effect.Key-words: heart rate variability, neonatal transport, sound, stress, whole-body vibration Key Notes: We have measured effects of sound and whole-body vibration on heart rate and heart rate variability on infants transported by air and ground ambulance. Sound and vibration during neonatal transport exceeded the recommended limits for adults. Neither sound nor whole-body vibration had an effect on heart rate variability, but high sound levels seems to cause a higher heart rate indicating a stressful effect on the infant while high vibration did not.

NeoSTRESS: Study of Transfer and Retrieval Environmental StressorS upon neonates via a smartphone application – Sound

“…1 Continuous equivalent sound (L eq ) exposure in the neonatal intensive care unit (NICU) is recommended to be less than 45 dB (dB), [2][3][4] with maximum transient sounds (L max ) to be below 65 dB. 4 There are a number of studies assessing noise during neonatal retrievals [5][6][7][8][9][10][11][12] but currently no recommendations regarding sound management during retrievals. Occupational standards in Australia recommend 8-h equivalent continuous sound pressure (L eq8h ) exposure of ≤85 dB, 13 thus pilots and other retrieval transport staff wear hearing protection during aircraft journeys.…”

Manejo del dolor en Neonatología

“…Distintos trabajos han evaluado los efectos del sonido, la vibración y la aceleración. [40][41][42] Karlsson 42 estudió la variabilidad de la FC en los bebés durante el transporte terrestre y aéreo, y observó que la vibración y el sonido excedían los niveles recomendados para los adultos. En los RN, el sonido parecería tener un efecto más estresante que las vibraciones.…”

Inter-hospital transport of newborns in critical condition: integrative literature review

“…12,13 Estudos sugeriram a utilização de protetores auditivos em RN durante o transporte. 21,22,23 Apesar de não constituírem elementos operacionais para a organização do transporte neonatal inter-hospitalar, e sim elementos de cuidados, representam pontos-chave que devem ser assegurados pela equipe que realizará o transporte.…”

“…A equipe que realizará o transporte deverá ter conhecimento sobre possíveis fontes de ruído e vibração, sendo orientada a evitar a utilização de sirenes, excesso de velocidade e conversas no interior da ambulância. 23 Para mensurar as alterações na hemodinâmica do RN transportado, investigando-se os efeitos do som e da vibração, os autores do estudo supracitado utilizaram o escore Transport Risk Index of Physiology Stability (TRIPS). Este foi criado após avaliações e estudo de transporte neonatal, considerando quatro variáveis que influenciaram como pior prognóstico durante a transferência inter-hospitalar: temperatura (de 0 a 8), padrão respiratório (de 0 a 14), pressão arterial sistólica (de 0 a 26) e estado neurológico (de 0 a 17).…”