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The effect of environmental lighting on the oxygen saturation of preterm infants in the NICU
Insights
Sudden light increases in the neonatal intensive care unit (NICU) may stress preterm infants. Younger premature infants showed no significant oxygen saturation changes when lights were lowered, but may be affected by rapid light increases.
Area of Science:
- Neonatal care
- Environmental physiology
Background:
- Premature infants are more susceptible to NICU environmental stressors due to immature neurological and physiological systems.
- Previous research focused on long-term light reduction effects, leaving a gap in understanding immediate light changes.
Purpose of the Study:
- To investigate the relationship between immediate environmental illumination changes and oxygen saturation in preterm neonates.
- To determine if gestational and postnatal age influence these changes.
Main Methods:
- Continuous oxygen saturation monitoring of 27 preterm infants (26-37 weeks gestation) over 40 minutes.
- Environmental illumination was decreased from 100 to 5 footcandles, then increased back.
- Oxygen saturation was recorded at set intervals following light alterations.
Main Results:
- A statistically significant interaction was found between repeated saturation measures and gestational/postnatal age.
- No significant oxygen saturation changes were observed in younger preterm infants when lights were decreased.
- The study suggests younger preterm infants may experience stress from rapidly increasing light levels.
Conclusions:
- Rapidly increasing environmental illumination may induce stress in preterm neonates, particularly those younger in gestational and postnatal age.
- Further research is needed to understand the long-term implications of light fluctuations in the NICU.
Abstract:
The premature infant is more vulnerable to the NICU environment than a full-term infant due to neurologic immaturity and physiologic instability. Studies have been done on the effects of long-term decreases in environmental light, but none have been done on the immediate effects. The purpose of this study was to determine the relationship between immediate changes in environmental illumination and oxygen saturation in preterm neonates and whether these were affected by gestational and postnatal age. The oxygen saturations of 27 sleeping infants (2 to 56 days of age) between 26 and 37 weeks gestation were continuously recorded for 40 minutes utilizing a Nellcor N200 oximeter. After recording baseline saturations for 5 minutes with the room lights at 100 footcandles, the illumination level was lowered to 5 footcandles. At the end of 30 minutes, lights were increased to the previous level. Oxygen saturations were recorded at one and five minutes after illumination decreases and increases. There was a statistically significant interaction between repeated measures of saturation at baseline and one and five minutes after lights were increased and covariates gestational, corrected gestational, and postnatal age (p = .02, p = .008, p = .005). Repeated measure analysis of covariance (ANCOVA) revealed no statistically significant changes in oxygen saturations after the lights had been lowered for babies who were younger in gestational or postnatal age. The results of this study suggest that rapidly increasing illumination may be a cause of stress to the younger gestationally and postnatally preterm neonate.