Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
Preterm Skin Contact Effect on Electrophysiologic Sleep
Susan M. Ludington, CNM, PhD, FAAN, Frances Payne Bolton School of Nursing, Frances Payne Bolton School of Nursing, Casw Western Reserve University, Cleveland, OH, USA
Objective: To test effect of Kangaroo Care (KC) on electrophysiologic- determined sleep patterns and to test for a significant increase in Quiet Sleep (QS) during KC as compared to incubator periods and between the treatment and control groups. Design: Randomized controlled trial by computerized assignment. Population, Sample, Setting, Years: 120 stable preterm infants (60 = KC, 60 = controls) tested at 32 ± 2 weeks post-conceptional age in a Level III Neonatal Intensive Care Unit over three years. Control: Infants, lie prone, and nested in a hooded Airshield Incubator for the pretest period (both groups) and test period (controls). KC: Infant, wearing only diaper, lies skin-to-skin against maternal chest for interfeeding interval as she reclines in lounger at bedside. Outcome variables: Computed for pretest and test periods separately. Each period = 2-3 hours (from one feed until next.) The number of seconds of discontinous pattern (quiet sleep) is counted per minute of recording, number of arousals per sleep epoch, # of Rapid Eye Movements (indicates healthy active sleep), # of sleep cycles (awake-sleep-awake). Methods: 8 channel EEG, 2 channel electro-oculogram, and 1 channel (2 electrode) electromyogram is continuously recorded in real time, with simultaneous video of infant’s face, using a Nihon-Koden Neurofax data collection system. Rapid eye movements (REMs) are annotated minute-by-minute. Tracings are scored by blinded pediatric neurologist. Statistics: ACCESS data analyzed by STATA using linear, logistic, or Poisson regression analysis as needed. Calculations over time intervals is accomplished by “non-lagged” analysis. Findings: 21 infants studied to date; all data will be reported at meeting. KC group shows more cycles, fewer arousals, and a difference in # of REMs. Conclusions: Data is preliminary but encouraging. More extensive data set is needed prior to making recommendations for nursing practice. Implications: Suggests that improvement in sleep patterns occur during KC
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