Claire Koenig Zores , Nicolas Mura , Elodie Rabatel , Meggane Melchior , André Dufour , Pierre Kuhn
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Abstract
Background
Care procedures for preterm infants can induce stress that may disrupt homeostasis, possibly altering cerebral perfusion or oxygenation. We evaluated the physiological and cerebral oxygenation changes during the routine care of very preterm infants.
Methods
We analyzed the changes in heart and respiratory rates and in systemic and regional cerebral oxygen saturation of 27 very preterm infants, defining three care periods of 5 min each: 30 min before care, 30 min during care, and 30 min after care. Mean maximum and minimum values for each parameter during the defined care periods were compared by analysis of variance (ANOVA) for repeated measures.
Results
The mean heart rate was significantly higher during (160 ± 8 bpm) than before and after care (151 ± 21 and 151 ± 6 bpm, respectively). The mean respiratory rate decreased during care and increased afterward: 44 ± 2.2, 40.6 ± 3.2, and 46.7 ± 3.4 cycles/min, respectively (p < 0.05). The mean regional cerebral oxygen and systemic saturation did not vary significantly. Mean minimum and maximum values for each parameter varied during and after care as compared with before care (all p < 0.01). The mean minimum cerebral and systemic saturation was lower after care than before care: 59 ± 8 % versus 63 ± 8 % and 83 ± 3 % versus 90 ± 7 %, respectively (p < 0.05).
Conclusions
During routine care procedures for very preterm infants, the change in physiological parameters suggested an autonomic stress reaction. Cerebral desaturation may occur during and after the care of such infants and call for specific attention to better support the physiological and cerebral well-being of these infants during standard care procedures.
期刊介绍：
Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics.
Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues.
All manuscripts submitted to the journal are subjected to peer review by international experts, and must:
Be written in excellent English, clear and easy to understand, precise and concise;
Bring new, interesting, valid information - and improve clinical care or guide future research;
Be solely the work of the author(s) stated;
Not have been previously published elsewhere and not be under consideration by another journal;
Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed.
Under no circumstances does the journal guarantee publication before the editorial board makes its final decision.
Archives de Pédiatrie is the official publication of the French Society of Pediatrics.
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