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Handling during neonatal intensive care
Insights
Handling intensive care newborns, especially very low birthweight infants, can have negative effects. Minimizing handling and optimizing procedures like endotracheal suctioning are crucial for infant well-being.
Area of Science:
- Neonatal intensive care
- Pediatric medicine
- Infant physiology
Background:
- Newborns in intensive care experience significant handling.
- The effects of this handling on infant well-being are not fully understood.
- Technological advancements may increase handling frequency.
Purpose of the Study:
- To quantify the amount and type of handling received by very low birthweight newborns.
- To assess the consequences of handling on these infants.
- To identify areas for reducing handling in neonatal intensive care.
Main Methods:
- Observational study of very low birthweight newborns in intensive care.
- Quantification of total handling time and procedures.
- Analysis of specific procedures like endotracheal suctioning and oxygen monitoring.
Main Results:
- Infants received an average of 4.3 hours (18%) of handling per day.
- Endotracheal suctioning was linked to hypoxemia and often suboptimal.
- Transcutaneous oxygen monitoring was inconsistent during handling periods.
Conclusions:
- Intensive handling in neonatal care can have adverse effects.
- Routine and innovative procedures require careful evaluation.
- Minimizing handling is essential for improving outcomes in sick newborns.
Abstract:
The handling received by very low birthweight newborns undergoing intensive care in the first few days of life and the effects of this were studied. Infants were handled an average of 4.3 hours (18%) of the total 24 hour observation time and received a mean 234 handling procedures. Parental handling contributed 35% of the total time but was usually benign except in that it could interfere with the infant's rest. Many procedures were associated with undesirable consequences. Endotracheal suctioning was invariably associated with hypoxaemia and was often carried out more frequently, or took longer, than was optimal. Transcutaneous oxygen monitoring, although considered routine for all intensive care infants, was only carried out for 50% of the observation time and often did not accompany periods of likely intensive handling. Increasing technology in neonatal intensive care often results in increased handling of sick infants. Each new innovation, as well as routine procedures, should be viewed in the light of the continuum of neonatal intensive care events, and handling kept to a minimum.
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