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The effects of environmental noise and infant position on cerebral oxygenation
Heather E Elser1, Diane Holditch-Davis, Janet Levy
1Duke University School of Nursing, Durham, North Carolina 27710, USA. heather.elser@duke.edu
Insights
Infant positioning in neonatal intensive care units (NICUs) impacts cerebral oxygenation more than sound levels. A right lateral, 15° head elevation position showed better cerebral oxygen saturation compared to other positions.
Area of Science:
- Neonatal physiology
- Neurodevelopmental science
- Clinical research
Background:
- Premature infants face unique challenges in the neonatal intensive care unit (NICU).
- Cerebral oxygen saturation is a critical indicator of brain health in neonates.
- Environmental factors in the NICU, such as sound and infant positioning, may influence physiological outcomes.
Purpose of the Study:
- To investigate the impact of different infant positions and peak sound levels on cerebral oxygen saturation in premature infants.
- To determine if environmental factors within the NICU affect cerebral oxygenation over time.
Main Methods:
- A repeated-measures design was employed with 24 premature infants (born <32 weeks gestational age).
- Cerebral oxygen saturation was monitored during 40-minute observation periods.
- Infant positions (supine, left lateral, right lateral with varying head elevation) and continuous sound levels (decibels) were varied.
Main Results:
- Peak sound levels 5 dB above ambient did not significantly alter cerebral oxygen saturation.
- Infant positioning significantly affected cerebral oxygenation, with a right lateral, 15° head elevation position showing improved outcomes compared to a left lateral, 0° elevation position.
Conclusions:
- Certain aspects of the NICU environment, specifically sound levels tested, do not appear to negatively impact cerebral oxygen saturation.
- Infant positioning is a modifiable factor that can influence cerebral oxygenation in premature infants.
Purpose:
To assess how different infant positions and peak sound levels affected cerebral oxygen saturation over time.
Subjects:
Twenty-four premature infants who were born less than 32 weeks' gestational age without congenital cardiac, neurologic, and gastrointestinal anomalies.
Design:
Repeated-measures design with the first observation between 2 and 48 hours of life; once again between 49 and 96 hours of life; on day of life 7; and every 7 days thereafter until discharge home, transfer to another hospital, or 40 weeks postmenstrual age, whichever came first.
Methods:
Continuous sound levels (decibels) were obtained and 2 infant positions were performed while measuring cerebral oxygen saturation during 40-minute observation periods.
Main Outcome Measures:
Effect of peak sound and differences in infant position on cerebral oxygen saturation.
Results:
Peak sound levels 5 dB above the average ambient sound level did not significantly change cerebral oxygen saturation values. Differences in cerebral oxygenation were significantly less when infants were changed from a supine, head midline position to a right lateral, 15° head elevation compared with a left lateral, 0° elevation position.
Conclusions:
Aspects of the current neonatal intensive care unit environment do not appear to affect cerebral oxygen saturation.
