The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

Tan, John B C; Boskovic, Danilo S.; Angeles, Danilyn M.

doi:10.3390/antiox7030037

Cited by 22 publications

(21 citation statements)

References 104 publications

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“…It is unclear why the heart rate response was muted in the oxygen group, especially because of the well-documented correlation between chemoreceptors and autonomic activity (19). This diminished response may be indicative of this group’s limited ability to respond to an increase in allostatic load (20,21). It is also possible that the smaller, younger babies on oxygen required less scleral depression, and therefore had less pain.…”

Section: Discussionmentioning

confidence: 99%

Differential effects of the retinopathy of prematurity exam on the physiology of premature infants

et al. 2019

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Objective: To compare the differential effects of the retinopathy of prematurity (ROP) examination on the physiology of premature infants with and without oxygen support. Study Design: We collected data from 42 premature infants (room air = 19, oxygen support = 23) and compared physiological metrics including heart rate (HR), systemic peripheral saturation (SpO 2 ), mesenteric tissue oxygen saturation (StO 2 ) and clinical events (oxygen desaturation episodes, bradycardia events, and gastric residuals). Results: We found significant differences between groups in HR during and briefly after the exam, and in mesenteric StO 2, during eye drop administration, eye exam, and up to 8 minutes after the exam. SpO 2 was significantly different between the groups at all time points. Gastric residuals were higher after the exam in infants on oxygen support, compared to baseline. Conclusion: Premature infants on oxygen support may be at a higher risk of adverse physiologic effects in response to the ROP exam.

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Section: Discussionmentioning

confidence: 99%

Differential effects of the retinopathy of prematurity exam on the physiology of premature infants

et al. 2019

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“…These infants are at increased risk, at least in part, because they are separated from their mothers in most NICUs and experiencing the negative consequences of such early maternal separation (Craig et al, 2016;Sutton & Darmstadt, 2013). Further, these infants are vulnerable to a variety of internal and external events that increase energy losses (Blass, 2015;Tan et al, 2018). Findings from a review of kangaroo mother care (KMC), in which a parent holds an infant skin-to-skin on their bare chest for extended periods of time, suggest that KMC reduces morbidity and mortality among premature infants and is associated with improved neonatal physiologic stability and decreased stress levels, as evidenced by lower infant cortisol levels (Chi Luong et al, 2016;Johnson, 2013;Pados, 2019).…”

mentioning

confidence: 99%

Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care

Forde

Deming

Tan

et al. 2020

Biological Research For Nursing

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Objective: Due to physiological and metabolic immaturity, prematurely born infants are at increased risk because of maternal separation in many neonatal intensive care units (NICUs). The stress induced from maternal–infant separation can lead to well-documented short-term physiologic instability and potentially lifelong neurological, sociological, or psychological sequelae. Based on previous studies of kangaroo mother care (KMC) that demonstrated improvement in physiologic parameters, we examined the impact of KMC on physiologic measures of stress (abdominal temperature, heart rate, oxygen saturation, perfusion index, near-infrared spectrometry), oxidative stress, and energy utilization/conservation in preterm infants. Methods: In this randomized, stratified study of premature neonates, we compared the effects on urinary concentrations of biomarkers of energy utilization and oxidative stress of 1 hr of KMC versus incubator care on Day 3 of life in intervention-group babies ( n = 26) and control-group babies ( n = 25), respectively. On Day 4, both groups received 1 hr of KMC. Urinary samples were collected 3 hr before and 3 hr after intervention/incubator care on both days. Energy utilization was assessed by measures of adenosine triphosphate (ATP) degradation (i.e., hypoxanthine, xanthine, and uric acid). Oxidative stress was assessed using urinary allantoin. Mixed-models analysis was used to assess differences in purine/allantoin. Results: Mean allantoin levels over Days 3 and 4 were significantly lower in the KMC group than in the control group ( p = .026). Conclusions: Results provide preliminary evidence that KMC reduces neonatal oxidative stress processes and that urinary allantoin could serve as an effective noninvasive marker for future studies.

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“…Consequently, these processes could lead to energy deficits. 6 One of the most important effects of energy deficit in preterm infants is low weight gain, which can affect brain development, and lead to poor growth and development. 7 Therefore, controlling paininduced physiological responses is key to preventing poor development in preterm infants.…”

Section: Resultsmentioning

confidence: 99%

Preterm infant physiological responses to music therapy: a systematic review

Liwang

Nadobudskaya

Lestari

et al. 2018

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Background Prematurity is still the leading cause of mortality and morbidity in neonates. The premature change of the environment causes stress, which leads to hemodynamic instability. Music therapy may have a positive impact on hemodynamic parameters of preterm infants in the NICU. Objective To evaluate preterm infants’ physiological responses to music therapy in NICU setting. Methods A systematic review was performed in 12 electronic databases from March 2000–April 2018. Our review included all English language publications on parallel or crossover RCTs of music therapy versus standard care or placebo in preterm infants. The outcomes were physiological indicators [heart rate (HR), respiratory rate (RR), and oxygen saturation (SaO2)]. Risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials (RoB 2.0). Results The search yielded 20 articles on 1,148 preterm infants of gestational age 28 and 37 weeks, who received recorded music, recorded maternal/male voice or lullaby, or live music interventions in the NICU with intensity of 30–76 dB. Recorded music improved all outcomes in 6, 6, and 4 of 16 studies for HR, RR, and SaO2, respectively. Seven studies used classical music as melodic elements. However, eight studies showed no significant results on all outcomes. Conclusion Despite the finding that music interventions demonstrate promising results in some studies, the variation in quality of the studies, age groups, outcome measures, as well as type and timing of the interventions across the studies make it difficult to draw overall conclusions about the effects of music in preterm infants.

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The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

Cited by 22 publications

References 104 publications

Differential effects of the retinopathy of prematurity exam on the physiology of premature infants

Differential effects of the retinopathy of prematurity exam on the physiology of premature infants

Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care

Preterm infant physiological responses to music therapy: a systematic review

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