Efeitos cardiorrespiratórios frente à posição do corpo em recém-nascidos pré-termo submetidos ao aumento do volume gástrico

Abstract

The increase of the gastric volume observed in the gavage feeding is likely to cause consequences to the premature newborn, modifying the respiratory indicators. To investigate the alterations in the cardiorespiratory system of premature newborns submitted to an increase of the gastric volume by gavage feeding, according to four different body positioning methods. The study is a randomized crossover trial using a sample of 16 newborns with gestational age from 31 to 34 weeks and birth weight less or equal to 2.500 g. The newborns were included in the study if they had from 7 to 10 days of life, feeding by orogastric tube, total volume of 150 mL/kg/day and absence of supplemental oxygen-therapy. A different positioning method was used at each gavage (all raised to 30 degrees), or say, right lateral, left lateral, prone and supine positions. The following response variables were considered: respiratory and cardiac frequencies, saturation of oxygen, drawing of intercostals, beating of nasal wing and grunting. These measures were collected in intervals of 2 minutes during 5 minutes after the gavage feeding, during whole period of the gavage feeding, and during 5 minutes before the gavage feeding. The mean gestational age was 32 weeks (standard deviation 1.3) and the mean weight of the newborns was 1.722 g (standard deviation 276.3). The newborns presented higher values of the mean respiratory frequency in supine and left lateral body positions. In the right lateral and prone positions, the newborns presented lower mean cardiac frequency. The mean oxygen saturation had the lowest values in the left lateral and supine positions. The right lateral and prone positions presented low frequencies of intercostals drawing, beating of nasal wing and grunting. Our results indicate that right lateral and prone positions have influence on the cardiorespiratory effect, where left lateral and supine are the positions who presented higher negative effect in the newborns submitted to the increase of the gastric volume.