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Effectiveness of the Bladder Stimulation Technique for Infant Urine Collection in the Pediatric Emergency Department:
Insights
The bladder stimulation technique improves urine collection success in infants aged 1-12 months but does not reduce procedure time. This method shows procedural feasibility with mild discomfort and no significant physiological changes.
Area of Science:
- Pediatrics
- Urology
- Clinical Trials
Background:
- Urine sample collection in non-toilet-trained infants presents significant challenges and limitations with current methods.
- The bladder stimulation technique is a novel approach to facilitate urine collection in infants.
Purpose of the Study:
- To evaluate the efficacy of the bladder stimulation technique for urine collection in infants aged 1 to 12 months.
- To assess procedure success rate, duration, pain, and physiological effects compared to standard positioning.
Main Methods:
- A randomized controlled trial involving 64 infants aged 1-12 months.
- Infants were assigned to either bladder stimulation or standard positioning.
- Data collected included urine collection success, procedure duration, and the Face, Legs, Activity, Cry, and Consolability (FLACC) pain scale.
Main Results:
- The bladder stimulation group demonstrated a significantly higher urine collection success rate (53.1% vs 25.0%, P = .021).
- Median procedure duration was not significantly different between groups (46 vs 82.5 seconds, P = .38).
- Mild increases in FLACC scores, heart rate, and decreases in oxygen saturation were observed in both groups, with no significant between-group differences.
Conclusions:
- The bladder stimulation technique enhances procedural urine collection success within a 3-minute window in infants.
- The technique did not significantly reduce procedure duration but was associated with mild discomfort.
- Findings support the short-term procedural feasibility of bladder stimulation, not its diagnostic adequacy.
Introduction:
Collecting urine samples from nontoilet-trained infants is challenging and time-consuming, and current methods have notable limitations. This study aimed to evaluate the success rate, procedure duration, pain, and physiological effects of the bladder stimulation technique in infants aged 1 to 12 months.
Methods:
In this randomized controlled trial, 64 infants were assigned to either an experimental group receiving the bladder stimulation technique or a control group with standard positioning. Data were obtained using a structured form and the face, legs, activity, cry, and consolability (FLACC) pain scale. The procedure was considered successful if urine was collected within 3 minutes, and the procedure duration was measured as the time until urine collection. Heart rate, oxygen saturation, and FLACC scores were recorded at baseline and at the first and third minutes of the intervention.
Results:
The experimental group had a higher urine collection success rate than the control group (53.1% vs 25.0%; P = .021), with a relative risk of 2.13 (95% CI, 1.05-4.30) and an absolute risk difference of 28.1% (95% CI, 5.8%-50.4%). Median procedure duration did not differ significantly between the groups (46 vs 82.5 seconds; P = .38). FLACC scores increased over time in both groups (P < .001), with a rise from 2 to 3 points in the experimental group (P < .001) but not in the controls (P = .30). Heart rate increased and peripheral oxygen saturation decreased in both groups (P < .001), without between-group differences (P > .05).
Discussion:
The bladder stimulation technique increased the success of procedural urine collection within a predefined 3-minute window in infants aged 1 to 12 months. However, it did not significantly reduce the duration of the procedure. The technique was associated with mild discomfort and no clinically concerning physiological changes under standardized study conditions. Because contamination rates, urine culture validity, and subsequent urine collection procedures were not assessed, these findings support the short-term procedural feasibility rather than diagnostic adequacy.
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