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Updated: Jul 9, 2025
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Parental holding of infants improves haemodynamics in the cardiac ICU
Justin J Elhoff1, Sebastian Acosta2, Saul Flores2
1Department of Pediatrics, Pediatrix Medical Group, Sunrise Children's Hospital, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA.
Insights
Parental holding of infants in the cardiac intensive care unit (ICU) is safe and beneficial. Holding led to a decrease in heart rate and an increase in venous saturation, indicating positive physiologic changes for these young patients.
Area of Science:
- Pediatrics
- Cardiology
- Intensive Care Medicine
Background:
- Infants in cardiac intensive care units (ICUs) often experience physiological stress.
- Parental presence and interaction are crucial for infant well-being.
- The impact of parental holding on physiological parameters in this vulnerable population requires further investigation.
Purpose of the Study:
- To assess the physiological changes in infants within a cardiac ICU when held by a parent.
- To determine the safety and haemodynamic effects of parental holding in this setting.
Main Methods:
- A single-centre, retrospective study was conducted.
- Continuous vital sign data were collected from infants between January 2021 and March 2022.
- Mixed-effects models were used to analyze physiological data, controlling for clinical factors.
Main Results:
- No immediate adverse events were observed during parental holding.
- Heart rate decreased significantly (p = 0.01) during holding, particularly in non-intubated and pre-operative infants.
- Near-infrared spectroscopy-based venous saturation increased overall (p = 0.02) while infants were held.
Conclusions:
- Parental holding is safe for infants in the cardiac ICU.
- Holding promotes favourable haemodynamic and oximetric changes compared to baseline.
- Encouraging parental presence can be a valuable non-pharmacological intervention in pediatric cardiac care.
Abstract:
We performed a single-centre, retrospective study to assess physiologic changes of infants in the cardiac ICU while being held by their parent. Continuous data streaming of vital signs were collected for infants included in the study from January 2021 to March 2022. Demographic and clinical characteristics were collected from the electronic medical record. The physiologic streaming data were analysed using mixed-effects models to account for repeated measures and quantify the effect of parental holding. Comparison analysis was also performed controlling for intubation, pre-operative versus post-operative status, and whether the holding was skin-to-skin or not. Ninety-five patients with complete physiologic data were included in the study. There were no immediate adverse events associated with holding. Heart rate decreased during the response time compared to its baseline value (p = 0.01), and this decrease was more pronounced for the non-intubated and pre-operative patients. The near-infrared spectroscopy-based venous saturation increased overall (p = 0.02) in patients while being held. We conclude that parental holding of infants in the cardiac ICU can be safely accomplished, and the haemodynamic and oximetric profile during the holding is favourable compared to the infants' baseline prior to holding.
