Document Detail


Effect of nursing in the head elevated tilt position (15 degrees) on the incidence of bradycardic and hypoxemic episodes in preterm infants.
MedLine Citation:
PMID:  9310515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We investigated whether nursing in the head elevated tilt position (HETP), compared with the horizontal position, has any effect on the incidence of bradycardic and hypoxemic episodes in preterm infants. METHODS: Twelve spontaneously breathing preterm infants with idiopathic recurrent apnea were studied in a randomized controlled crossover trial. Nine infants were treated with aminophylline. Each spent a total of 24 hours in the horizontal prone position and a total of 24 hours in HETP (prone, 15 degrees). The position was changed in random order every 6 hours. Thoracic impedance, heart rate, and arterial oxygen saturation were recorded continuously. The frequency of isolated hypoxemia (arterial saturation <80%), of isolated bradycardia (heart rate <90 beats per minute), and of mixed events was analyzed and compared without knowledge of the allocated position. RESULTS: In total, there were significantly fewer bradycardic and/or hypoxemic episodes (28.2%) in HETP compared with the horizontal position (mean difference, 13.35 episodes/24 hours; 95% confidence interval [CI]: 5.9- 20.8). The decrease was largest for isolated hypoxemic episodes (48.5%; mean difference, 11.74 episodes/24 hours; 95% CI: 6.1-17.4). Isolated bradycardic episodes (mean difference, 2.27 episodes/24 hours; 95% CI: -0.78-5.31) and mixed events were not decreased significantly in HETP. CONCLUSIONS: Nursing in a moderately tilted position (15 degrees) reduces hypoxemic events in preterm infants. This intervention is easy to apply, quickly reversible, and can be combined with drugs such as aminophylline.
Authors:
O G Jenni; K von Siebenthal; M Wolf; M Keel; G Duc; H U Bucher
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pediatrics     Volume:  100     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-10-14     Completed Date:  1997-10-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  622-5     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Clinic, University Hospital, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Anoxia / prevention & control*
Apnea / prevention & control
Bradycardia / prevention & control*
Cross-Over Studies
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / nursing,  prevention & control*
Male
Nursing Care / methods*
Posture*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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