Nursing procedures and alterations in transcutaneous oxygen tension in premature infants

This study evaluated the effects of three routine nursing procedures--suctioning, repositioning, and performing a heelstick--on blood oxygen levels in premature infants, using a transcutaneous oxygen (Tcp02) monitor. Twenty-five infants with respiratory distress syndrome were monitored for three hours during which all three procedures were performed. Continuous Tcp02 records were used for measurement of baseline Tcp02 degree and duration of Tcp02 changes, length of procedural time, and rest time prior to procedures. Data were analyzed to determine if Tcp02 was altered during routine procedures, and if the degree of change was affected by length of procedure or length of rest prior to a procedure. Degree of Tcp02 change was analyzed in relation to length of time taken to recover from procedures. Tcp02 was decreased significantly during suctioning and repositioning but not during heelstick. The three procedures resulted in different degrees of change in Tcp02. Suctioning elicited the greatest decrease, followed by respositioning then heelstick. Recovery time was related to the degree of change in Tcp02 only after the repositioning procedure. Length of procedure and rest time did not relate to the degree of change in Tcp02, suggesting that it was the type of procedure that determined infant response.