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    Physiological stress responses in infants at 29-32 weeks' postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments.

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    Author
    Allinson, LG; Denehy, L; Doyle, LW; Eeles, AL; Dawson, JA; Lee, KJ; Spittle, AJ
    Date
    2017
    Source Title
    BMJ Paediatrics Open
    Publisher
    BMJ
    University of Melbourne Author/s
    Doyle, Lex; Denehy, Linda; Spittle, Alicia
    Affiliation
    Obstetrics and Gynaecology
    Melbourne School of Health Sciences
    Physiotherapy
    Metadata
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    Document Type
    Journal Article
    Citations
    Allinson, L. G., Denehy, L., Doyle, L. W., Eeles, A. L., Dawson, J. A., Lee, K. J. & Spittle, A. J. (2017). Physiological stress responses in infants at 29-32 weeks' postmenstrual age during clustered nursing cares and standardised neurobehavioural assessments.. BMJ Paediatr Open, 1 (1), pp.e000025-. https://doi.org/10.1136/bmjpo-2017-000025.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/254748
    DOI
    10.1136/bmjpo-2017-000025
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842990
    Abstract
    Objective: To compare the physiological stress responses of infants born <30 weeks' gestational age when undergoing clustered nursing cares with standardised neurobehavioural assessments in neonatal nurseries. Design/methods: Thirty-four infants born <30 weeks' gestation were recruited from a tertiary neonatal intensive care unit. Heart rate (HR) and oxygen saturation were recorded during clustered nursing cares and during standardised neurobehavioural assessments (including the General Movements Assessment, Hammersmith Neonatal Neurological Examination and Premie-Neuro Assessment). Two assessors extracted HR and oxygen saturations at 5 s intervals, with HR instability defined either as tachycardia (HR >180 beats per minute (bpm)) or bradycardia (HR <100 bpm). Oxygen desaturations were defined as SpO2<90%. Physiological stability was compared between nursing cares and neurobehavioural assessments using linear (for continuous outcomes) and logistic (HR instability and oxygen desaturation) regression. Results: Compared with clustered nursing cares HR was lower (mean difference -5.9 bpm; 95% CI -6.5 to 5.3; P<0.001) and oxygen saturation higher (mean difference 2.4%; 95% CI 2.1% to 2.6%; P<0.001) during standardised neurobehavioural assessments. Compared with clustered nursing cares neurobehavioural assessments were also associated with reduced odds of tachycardia (OR 0.44, 95% CI 0.22 to 0.86), HR instability (OR 0.43, 95% CI 0.22 to 0.85) and oxygen desaturation (OR 0.43, 95% CI 0.26 to 0.70). Conclusions: Standardised neurobehavioural assessments are associated with less physiological stress than clustered nursing cares in infants aged 29-32 weeks' postmenstrual age, and are therefore possible without causing undue physiological disturbance in medically stable infants.

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