Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial

Janneke Dekker; Stuart B Hooper; Tessa Martherus; Sophie J E Cramer; Nan van Geloven; Arjan B Te Pas

doi:10.1016/j.resuscitation.2018.03.030

Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial

Resuscitation. 2018 Jun:127:37-43. doi: 10.1016/j.resuscitation.2018.03.030. Epub 2018 Mar 23.

Authors

Janneke Dekker¹, Stuart B Hooper², Tessa Martherus³, Sophie J E Cramer⁴, Nan van Geloven⁵, Arjan B Te Pas³

Affiliations

¹ Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.dekker@lumc.nl.
² The Ritchie Center, MIMR-PHI Institute of Medical Research, Melbourne, Australia.
³ Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Department of Instrumental Affairs, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Department of Medical Statistics and Bio-informatics, Leiden University Medical Center, Leiden, The Netherlands.

PMID: 29580959
DOI: 10.1016/j.resuscitation.2018.03.030

Abstract

Aim: To evaluate the direct effect of repetitive tactile stimulation on breathing effort of preterm infants at birth.

Methods: This randomized controlled trial compared the effect of repetitive stimulation on respiratory effort during the first 4 min after birth with standard stimulation based on clinical indication in preterm infants with a gestational age of 27-32 weeks. All details of the stimulation performed were noted. The main study parameter measured was respiratory minute volume, other study parameters assessed measures of respiratory effort; tidal volumes, rate of rise to maximum tidal volumes, percentage of recruitment breaths, and oxygenation of the infant.

Results: There was no significant difference in respiratory minute volume in the repetitive stimulation group when compared to the standard group. Oxygen saturation was significantly higher (87.6 ± 3.3% vs 81.7 ± 8.7%, p = .01) while the amount of FiO₂ given during transport to the NICU was lower (28.2 (22.8-35.0)% vs 33.6 (29.4-44.1)%, p = .04). There was no significant difference in administration of positive pressure ventilation (52% vs 78%, p = .13), or the duration of ventilation (median (IQR) time 8 (0-118)s vs 35 (13-131)s, p = .23). Caregivers decided less often to administer caffeine in the delivery room to stimulate breathing in the repetitive stimulation group (10% vs 39%, p = .036).

Conclusion: Although the increase in respiratory effort during repetitive stimulation did not reach significance, oxygenation significantly improved with a lower level of FiO₂ at transport to the NICU. Repetitive tactile stimulation could be of added value to improve breathing effort at birth.

Keywords: Breathing; Preterm infant; Stimulation.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Continuous Positive Airway Pressure
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature*
Male
Oxygen Consumption*
Physical Stimulation / methods*
Single-Blind Method
Tidal Volume*