The effect of abdominal massage (I Love You method) on the gastric function of preterm infants hospitalized in the neonatal intensive care units: a randomized clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azadeh Moghadam ◽  
Monirsadat Nematollahi ◽  
Hamid OstadEbrahimi ◽  
Roghayeh Mehdipour-Rabori
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Abdominal Circumference ◽  
Average Weight ◽  
Gastric Function ◽  
Gastrointestinal Problems ◽  
Before And After ◽  
Massage Group ◽  
Abdominal Massage

Abstract Objectives Preterm infants often suffer from nutritional problems because of gastrointestinal problems. Massage could make the infants feel more peace and comfort, but limited studies have focused on the effects of massage on the gastric function. This study aimed to investigate the effects of abdominal massage on the gastric function of preterm infants. Methods A randomized controlled trial compared gastric function of preterm infants with and without massage therapy. The preterm infants were randomly allocated to control and massage groups. The massage group received the abdominal massage before feeding, twice a day, for 15 min, over 5 days. Furthermore, the gastric function was compared between the control and experimental groups. The data were analyzed using SPSS software (Version 15.0). Results The average weight in both groups had no significant (p>0.05) changes before and after the study, and both groups showed a negative trend in the weight gain. The abdominal circumference, the frequency of vomiting episodes, the residual volume, and defecation frequency were significantly (p<0.05) different between the two groups after the intervention. Conclusions The abdominal massage could be an effective nonmedicinal method to reduce the gastrointestinal problems in the preterm infants. The abdominal massage could be offered to the preterm infants as an inexpensive, available, and feasible method to alleviate gastrointestinal problems as well as improve the gastric function.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

Nonpharmacological Techniques to Reduce Pain in Preterm Infants Who Receive Heel-Lance Procedure: A Randomized Controlled Trial

2014 ◽  
Vol 28 (4) ◽  
pp. 335-348 ◽  
Author(s):  
Piera Bergomi ◽  
Michele Chieppi ◽  
Antonella Maini ◽  
Tiziana Mugnos ◽  
Debora Spotti ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Wolfgang Amadeus Mozart ◽  
Controlled Trial ◽  
Standard Procedure ◽  
Blood Collection ◽  
Randomized Controlled ◽  
Heel Lance

Introduction: The heel-lance (HL) method for blood collection from the newborn is controversial for the pain it causes. This is the first randomized controlled trial on the management and reduction of pain using the music of Wolfgang Amadeus Mozart (“Sonata K. 448”) in premature infants hospitalized in a neonatal intensive care unit (NICU). This study has compared nonpharmacological techniques with standard procedure for reducing pain during HL procedure. Methods: Thirty-five premature infants were enrolled, each for 3 HL procedures, of which each was randomized to 1 of the 3 study arms. Arms were then compared in terms of the Premature Infant Pain Profile (PIPP) changes by analysis of variance (ANOVA). Results: One hundred five HL procedures were available for analysis (35 standard procedure, 35 music, 35 glucose). Median baseline PIPP was 3, and median PIPP after the HL procedure was 5. PIPP scale change was +3 in the control arm, +1 in the glucose arm, +2 in the music arm (p = .008). Discussion: Both glucose and music were safe and effective in limiting pain increase when compared to standard procedure in HL procedures in preterm infants.

The Effect of the Transfusion Protocol on Transfusion Rates and Short-term Outcomes of Preterm Infants in a Tertiary Neonatal Intensive Care Unit

2021 ◽  
Author(s):  
Emel Okulu ◽  
Yasemin Ezgi Kostekci ◽  
Elvis Kraja ◽  
Omer Erdeve ◽  
Saadet Arsan ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Inverse Relationship ◽  
Short Term ◽  
Total Blood ◽  
Period 2 ◽  
Before And After ◽  
Transfusion Guidelines ◽  
Transfusion Protocol ◽  
Rbc Transfusion

Background: The aim of this study was to compare the epochs before and after the revision of the transfusion guideline, and determine their effects on transfusion rates and short-term outcomes in preterm infants. Materials and Methods: This retrospective study was conducted to investigate the effect of the new transfusion guideline. Infants who were born <32 weeks of gestation and received red blood cell (RBC) transfusion in their first 6-weeks of life were divided into two epochs according to adopting the new transfusion guideline. The demographic and clinical data of the patients were compared between these two periods. Results: Fifty-six infants were included (Period 1, n=22; Period, n=34). The number of transfusions, total and cumulative volume of the transfusions were similar in the two periods. There was an inverse relationship between the gestational age and the number of transfusions in both periods (r=-0.575, p=0.005, and r=-0.494, p=0.003), and there was an inverse relationship between the birth weight and the number of transfusions in period 2 (r=-0.423, p=0.013). The ratio of total phlebotomy volume to estimated total blood volume was higher in period 2 (p=0.029). There was a direct relationship between the phlebotomy loss and volume of RBC transfused in period 2 (r=0.487, p=0.003). The incidence of morbidities was similar in the two periods. Conclusion: Changing only the transfusion protocol did not decrease the transfusion number. Although transfusion guidelines were adopted rigorously, it seems to be impossible to reduce RBC transfusion rates unless anemia prevention strategies were also in place.

scholarly journals Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025062 ◽  
Author(s):  
Claire Ghetti ◽  
Łucja Bieleninik ◽  
Mari Hysing ◽  
Ingrid Kvestad ◽  
Jörg Assmus ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Developmentally Appropriate ◽  
Well Being ◽  
Positive Effects ◽  
Implementation And Dissemination ◽  
Randomised Controlled

IntroductionPreterm birth has major medical, psychological and socioeconomic consequences worldwide. Music therapy (MT) has positive effects on physiological measures of preterm infants and maternal anxiety, but rigorous studies including long-term follow-up are missing. Drawing on caregivers’ inherent resources, this study emphasises caregiver involvement in MT to promote attuned, developmentally appropriate musical interactions that may be of mutual benefit to infant and parent. This study will determine whether MT, as delivered by a qualified music therapist during neonatal intensive care unit (NICU) hospitalisation and/or in home/municipal settings following discharge, is superior to standard care in improving bonding between primary caregivers and preterm infants, parent well-being and infant development.Methods and analysisDesign:international multicentre, assessor-blind, 2×2 factorial, pragmatic randomised controlled trial; informed by a completed feasibility study.Participants:250 preterm infants and their parents.Intervention:MT focusing on parental singing specifically tailored to infant responses, will be delivered during NICU and/or during a postdischarge 6-month period.Primary outcome:changes in mother–infant bonding at 6-month corrected age (CA), as measured by the Postpartum Bonding Questionnaire.Secondary outcomes: mother–infant bonding at discharge and at 12-month CA; child development over 24 months; and parental depression, anxiety and stress, and infant rehospitalisation, all over 12 months.Ethics and disseminationThe Regional Committees for Medical and Health Research Ethics approved the study (2018/994/REK Nord, 03 July 2018). Service users were involved in development of the study and will be involved in implementation and dissemination. Dissemination of findings will apply to local, national and international levels.Trial registration numberNCT03564184

scholarly journals The effect of smell and taste of milk during tube feeding of preterm infants (the Taste trial): a protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027805 ◽  
Author(s):  
Friederike Beker ◽  
Judith Macey ◽  
Helen Liley ◽  
Ian Hughes ◽  
Peter G Davis ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Controlled Trial ◽  
Tube Feeding ◽  
Growth Failure ◽  
Neurodevelopmental Outcomes ◽  
Very Preterm Infants ◽  
Reference Number ◽  
Discharge From Hospital

IntroductionSmell and taste of milk are not generally considered when tube feeding preterm infants. Preterm infants have rapid growth, particularly of the brain, and high caloric needs. Enteral feeding is often poorly tolerated which may lead to growth failure and long-term neurodevelopmental impairment. Smell and taste are strong stimulators of digestion and metabolism. We hypothesise that regular smell and taste during tube feeding will improve weight z-scores of very preterm infants at discharge from hospital.Methods and analysisTaste is a randomised, unblinded two-centre trial. Infants born at <29 weeks’ gestation and/or <1250 g at birth and admitted to a participating neonatal intensive care unit are eligible. Randomisation occurs before infants receive two hourly feeds for 24 hours. Infants are randomised to either smell and taste of milk with each tube feed or tube feeding without the provision of smell and taste. The primary outcome is weight z-score at discharge. Secondary outcomes include: days to full enteral feeds, duration of parenteral nutrition, rate of late-onset sepsis, post menstrual age at removal of nasogastric tube and at discharge from hospital, anthropometric data and neurodevelopmental outcomes at 2 years of corrected age.Ethics and disseminationHuman Research Ethics Committees of Mater Misericordiae (trial reference number: HREC/16/MHS/112) and the Royal Women’s Hospital (trial reference number: 17/21) last approved the trial protocol (version 4.2; Date: 18 December 2018) and recruitment commenced in May 2017 and November 2017, respectively. The trial results will be published in a peer-reviewed journal and will be presented at national and international conferences.Trial registration numberACTRN12617000583347.

Association of Resident Duty Hour Reform and Neonatal Outcomes of Very Preterm Infants

2017 ◽  
Vol 34 (14) ◽  
pp. 1396-1404
Author(s):  
Bruno Piedboeuf ◽  
Robert Platt ◽  
Keith Barrington ◽  
Victoria Bizgu ◽  
Prakesh Shah ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Neonatal Intensive Care Units ◽  
Composite Outcome ◽  
Major Morbidity ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Before And After ◽  
Resident Duty

Objective To assess the association of the 2011 Quebec provincial resident duty hour reform, which reduced the maximum consecutive hours worked by all residents from 24 to 16 hours, with neonatal outcomes. Study Design Retrospective observational study of 4,271 infants born between 23 and 32 weeks, admitted at five Quebec neonatal intensive care units (NICUs) participating in the Canadian Neonatal Network (CNN) between 2008 and 2015 was conducted. Adjusted odds ratios (AORs) were calculated to compare mortality and the composite outcome of mortality or major morbidity before and after the implementation of the duty hour reform. Results The mortality rate was 8.4% (218/2,598) before the resident duty hour reform and 8.6% (182/2,123) after the reform (odds ratio [OR] = 1.02, 95% confidence interval [CI] = 0.83–1.26). The composite outcome rate was 32% (830/2,598) before the duty hour reform and 29% (615/2,123) after the reform (OR = 0.87, 95% CI = 0.77–0.98). In the adjusted analyses, the resident call-hour reform was not associated with a significant change in mortality (AOR = 1.17, 95% CI = 0.91–1.50) or composite outcome (AOR = 0.87, 95% CI = 0.74–1.03). Conclusion Reducing residents' duty hours from 24 to 16 hours in Quebec was not associated with a difference in mortality or the composite outcome of very preterm infants.

scholarly journals Role of probiotics in preterm infants: a randomized controlled trial

2017 ◽  
Vol 4 (2) ◽  
pp. 447 ◽  
Author(s):  
Sukanyaa S. ◽  
Vinoth S. ◽  
Ramesh S.
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Controlled Trial ◽  
Health Benefit ◽  
Control Group ◽  
P Value ◽  
Average Weight ◽  
Preterm Babies ◽  
Average Weight Gain

Background: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Probiotics are proposed to aid in the quicker colonisation of the preterm gut by various mechanisms thereby providing innumerable health benefits to the preterm infants. Hence we conducted a study to analyse the role of probiotics in preterm babies. Our primary aim was to compare the weight gain pattern among preterm infants: those receiving probiotic and those who did not receive the probiotic.Methods: Preterm/VLBW babies were selected, randomized and placed into two groups. One group was given the chosen probiotic and the other was kept as control. The weight gain pattern and the duration of hospital stay among the two groups was compared at the end of one month of age.Results: The average weight gain in the probiotic group was higher than the control group which was statistically significant. (mean difference: 0.230 + 0.11 95% CI: -0.796 to -0.251 p value <0.000).Conclusions: Our study was yet another evidence proving the utility of probiotics in the field of neonatalogy.

scholarly journals Cost-effectiveness of strategies preventing late-onset infection in preterm infants

2019 ◽  
Vol 105 (5) ◽  
pp. 452-457
Author(s):  
Alessandro Grosso ◽  
Rita Isabel Neves de Faria ◽  
Laura Bojke ◽  
Chloe Donohue ◽  
Caroline Isabel Fraser ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Life Expectancy ◽  
Preterm Infants ◽  
Healthcare Costs ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Controlled Trial ◽  
Cost Effective ◽  
Life Years ◽  
Late Onset Infection

ObjectiveDeveloping a model to analyse the cost-effectiveness of interventions preventing late-onset infection (LOI) in preterm infants and applying it to the evaluation of anti-microbial impregnated peripherally inserted central catheters (AM-PICCs) compared with standard PICCs (S-PICCs).DesignModel-based cost-effectiveness analysis, using data from the Preventing infection using Antimicrobial Impregnated Long Lines (PREVAIL) randomised controlled trial linked to routine healthcare data, supplemented with published literature. The model assumes that LOI increases the risk of neurodevelopmental impairment (NDI).SettingNeonatal intensive care units in the UK National Health Service (NHS).PatientsInfants born ≤32 weeks gestational age, requiring a 1 French gauge PICC.InterventionsAM-PICC and S-PICC.Main outcome measuresLife expectancy, quality-adjusted life years (QALYs) and healthcare costs over the infants’ expected lifetime.ResultsSevere NDI reduces life expectancy by 14.79 (95% CI 4.43 to 26.68; undiscounted) years, 10.63 (95% CI 7.74 to 14.02; discounted) QALYs and costs £19 057 (95% CI £14 197; £24697; discounted) to the NHS. If LOI causes NDI, the maximum acquisition price of an intervention reducing LOI risk by 5% is £120. AM-PICCs increase costs (£54.85 (95% CI £25.95 to £89.12)) but have negligible impact on health outcomes (−0.01 (95% CI −0.09 to 0.04) QALYs), compared with S-PICCs. The NHS can invest up to £2.4 million in research to confirm that AM-PICCs are not cost-effective.ConclusionsThe model quantifies health losses and additional healthcare costs caused by NDI and LOI during neonatal care. Given these consequences, interventions preventing LOI, even by a small extent, can be cost-effective. AM-PICCs, being less effective and more costly than S-PICC, are not likely to be cost-effective.Trial registration numberNCT03260517.

Direct swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial

2021 ◽  
pp. fetalneonatal-2021-321945
Author(s):  
Ju Sun Heo ◽  
Ee-Kyung Kim ◽  
Sae Yun Kim ◽  
In Gyu Song ◽  
Young Mi Yoon ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Tube Feeding ◽  
Tertiary Hospital ◽  
Oral Feeding ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Randomised Controlled

ObjectiveTo evaluate the effects of direct swallowing training (DST) alone and combined with oral sensorimotor stimulation (OSMS) on oral feeding ability in very preterm infants.DesignBlinded, parallel group, randomised controlled trial (1:1:1).SettingNeonatal intensive care unit of a South Korean tertiary hospital.ParticipantsPreterm infants born at <32 weeks of gestation who achieved full tube feeding.InterventionsTwo sessions per day were provided according to the randomly assigned groups (control: two times per day sham intervention; DST: DST and sham interventions, each once a day; DST+OSMS: DST and OSMS interventions, each once a day).Primary outcomeTime from start to independent oral feeding (IOF).ResultsAnalyses were conducted in 186 participants based on modified intention-to-treat (63 control; 63 DST; 60 DST+OSMS). The mean time from start to IOF differed significantly between the control, DST and DST+OSMS groups (21.1, 17.2 and 14.8 days, respectively, p=0.02). Compared with non-intervention, DST+OSMS significantly shortened the time from start to IOF (effect size: −0.49; 95% CI: −0.86 to –0.14; p=0.02), whereas DST did not. The proportion of feeding volume taken during the initial 5 min, an index of infants’ actual feeding ability when fatigue is minimal, increased earlier in the DST+OSMS than in the DST.ConclusionsIn very preterm infants, DST+OSMS led to the accelerated attainment of IOF compared with non-intervention, whereas DST alone did not. The effect of DST+OSMS on oral feeding ability appeared earlier than that of DST alone.Trial registration numberClinicalTrials.gov Registry (NCT02508571).

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