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Published on: March 14, 2013
A preliminary study of bottom care effects on premature infants' heart rate and oxygen saturation
Wang Yung-Weng1, Chang Ying-Ju
1Nursing Department, Chi-Mei Foundation Medical Center.
Insights
Buttock care (BC) significantly impacts premature infant physiological stability, affecting heart rate and oxygen saturation. The angle of buttock lifting during care influences these changes, necessitating careful monitoring.
Area of Science:
- Neonatal care
- Infant physiology
- Pediatric nursing
Background:
- Premature infants exhibit unique physiological vulnerabilities.
- Buttock care (BC) is a routine procedure in neonatal intensive care units (NICUs).
- The physiological impact of BC on premature infants requires further investigation.
Purpose of the Study:
- To investigate the effect of buttock care (BC) on premature infant heart rate (HR) and oxygen saturation (SpO2).
- To determine the influence of buttock lifting angle during BC on infant HR and SpO2.
- To assess the physiological stability of premature infants during BC procedures.
Main Methods:
- Repeated measure design with 11 premature infants in the NICU.
- Measurement of HR and SpO2 at 30-second intervals before, during, and after BC.
- Recording of maximal buttock lifting angles during 30 BC events.
Main Results:
- 63.3% of BC events induced significant HR increase and SpO2 decrease.
- 30% of BC events resulted in cardiac decelerations with recovery times over 10 minutes.
- HR accelerations were associated with lifting angles ≤30 degrees, while decelerations occurred with angles >30 degrees (p=.035).
Conclusions:
- Buttock care significantly impacts premature infant physiological stability.
- The buttock lifting angle is a critical factor influencing HR changes during BC.
- Close monitoring of premature infants before and after BC is recommended to ensure stability.
Abstract:
The purposes of this study were to explore (1) the effect of buttock care (BC) on premature infant heart rate (HR) and oxygen saturation (SpO(2)), and (2) the effect of buttock lifting angle during BCs on HR and SpO(2). The study used a repeated measure design. A convenience sample of 11 premature infants in the neonatal intensive care unit (NICU) of a medical center were studied during 30 BC events. The subjects were of a gestational age of less than and 37 weeks, and postnatal age of less than one month, without known congenital abnormalities and without having been treated with sedatives during the study. Infant HR and SpO(2) were measured at a 30-second interval 10 minutes before and during, and 15 minutes after BC. Maximal lifting angles of BCs during the procedure were recorded. Based on the infant's individual responses to BC, 63.3% of BCs induced an increase in HR and a decrease in SpO(2), defined as the change in HR and SpO(2) greater than two standard deviations from the baseline. In addition, 30% of BCs resulted in cardiac decelerations. The extent of the difference found in these change patterns in HR or SpO(2) were all significant (p <.01) and their mean recovery times were longer than 10 minutes. More HR acceleration events occurred as the BC lifting angle exceeded 30 degrees (p =.035). Buttock care can have a significant impact on premature infant physiological stability. The BC lifting angle may play an important role in HR acceleration or deceleration. Careful observation before and after BC for premature infants is recommended.
