Effectiveness of Hammock Positioning in Reducing Pain and Improving Sleep-Wakefulness State in Preterm Infants.

Abstract

Hammock positioning is now frequently used with preterm infants admitted to ICUs. However, few studies have investigated the extent to which hammock positioning reduces pain and improves the sleep-wakefulness state compared with traditional positioning. Twenty-six clinically stable newborns with gestational ages from 30 to 37 weeks who were breathing spontaneously were randomly assigned to 2 groups: a hammock-positioning group (n = 13), in which newborns were placed in hammocks in the lateral position, and a traditional-positioning group (n = 13), in which they were kept nested, also in the lateral position. The following variables were evaluated at the beginning and the end of the treatment: pain (with the Premature Infant Pain Profile, and Neonatal Facial Coding System), sleep-wakefulness state (with the Brazelton Neonatal Behavioral Assessment Scale), heart rate, breathing frequency, and peripheral SpO2 . The subjects in the hammock-positioning group showed an improvement in pain compared with the traditional-positioning group(Premature Infant Pain Profile score, 2.62 ± 1.89 vs 2.31 ± 1.97, ΔP = .008) and sleep-wakefulness state score (2.08 ± 0.64 vs 1.23 ± 0.44, Δ P < .001), reduced heart rate (151.69 ± 5.44 vs 142.77 ± 5.18 beats/min, Δ P < .001), breathing frequency (52.31 ± 4.05 vs 50.23 ± 2.55 beats/min, Δ P = .024), and increased peripheral SpO2 (94.69 ± 2.14 vs 98.00 ± 1.22%, Δ P < .001). Hammock positioning was an effective treatment option to reduce pain and improve sleep-wakefulness state. It also helped to reduce heart rate and breathing frequency, and to increase peripheral SpO2 , which made it a treatment option for preterm infants.