| Learning Objective #1: Describe parameters in the neonatal brain that indicate an increased risk for intraventricular hemorrhage | |||
| Learning Objective #2: Compare the cerebral blood flow response to heel stick versus heel prep in a preterm infant |
Objective: The purpose of this study was to determine if cerebral blood flow velocity was significantly different during a heel stick procedure when compared to a heel prep procedure in preterm infants 25 to 32 weeks gestational age. It was hypothesized that when Peak Systolic Velocity (PSV) increases and Resistive Index (RI) decreases in the presence of a lack of autoregulation and an evolving germinal matrix in the brain as seen in the premature infant, risk for Intraventricular Hemorrhage (IVH) increases.
Design: Randomized, two-period, two-treatment design, measured at baseline and then at six time points after each treatment.
Sample: Ten preterm infants.
Variables: The two primary outcome variables were PSV and RI obtained via a head ultrasound. Independent variables were treatment, heel stick versus heel prep only, and time.
Methods: During head ultrasound, baseline values were obtained and then the first treatment was administered followed by a 15 second, 1, 2, 3, 4, & 5 minute observation period. This was repeated after the second treatment.
Findings: A “high-risk” condition was defined to be an increase in PSV, accompanied by a concomitant decrease in RI. Six of the study subjects exhibited the “high-risk” condition following the heel stick. For three of the six, this occurred between 120 and 180 sec following the heel stick, for two it occurred between 180 and 240 sec following the stick, and for one it occurred between 15 and 60 sec following the stick. The gestational age of the six subjects ranged from 25 to 32 weeks, with a mean of 28.5 ± S.D. 2.6 weeks.
Conclusions: A painful stimulus does indeed cause a high risk condition in cerebral blood flow in the brain of the preterm infant.
Implications: Unmitigated pain may lead to an increase in neurodevelopmental sequelae in the preterm infant.
Back to Infant Care
Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003