Abstract
Tactile maneuvers to stimulate breathing in preterm infants are recommended during the initial assessment at birth, but it is not known how often and how this is applied. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth. Recordings of physiological parameters and videos of infants <32 weeks gestational age were retrospectively analyzed. Details of tactile stimulation during the first 7 min after birth (timing, duration, type, and indication) were noted. Stimulation was performed in 164/245 (67%) infants. The median (IQR) GA was 28 6/7 (27 2/7-30 1/7) weeks, birth weight 1,153 (880-1,385) g, Apgar score at 5 min was 8 (7-9), 140/245 (57%) infants were born after cesarean section, and 134/245 (55%) were male. There were no significant differences between the stimulated and the non-stimulated infants with regard to basic characteristics. In the stimulated infants, the first episode of stimulation was given at a median (IQR) of 114 (73-182) s after birth. Stimulation was repeated 3 (1-5) times, with a median (IQR) duration of 8 (4-16) s and a total duration of 32 (15-64) s. Modes of stimulation were: rubbing (68%) or flicking (2%) the soles of the feet, rubbing the back (12%), a combination (9%), or other (8%). In 67% of the stimulation episodes, a clear indication was noted (25% bradycardia, 57% apnea, 48% hypoxemia, 43% combination) and an effect was observed in 18% of these indicated stimulation episodes. A total effect of all stimulation episodes per infant remains unclear, but infants who did not receive stimulation were more often intubated in the delivery room (14/79 (18%) vs 12/164 (7%), p < 0.05). There was a large variation in the use of tactile stimulation in preterm infants during stabilization at birth. In most cases, there was an indication for stimulation, but only in a small proportion an effect could be observed.
Highlights
AND RATIONALEMost preterm infants initiate breathing after birth, but their respiratory drive is weak and often insufficient [1,2,3,4,5]
Experimental studies have shown a positive effect of tactile stimulation on spontaneous breathing at birth [10, 11], but there is very little human data demonstrating the effect of stimulation, especially in preterm infants
Tactile stimulation was performed in 164/245 (67%) infants
Summary
AND RATIONALEMost preterm infants initiate breathing after birth, but their respiratory drive is weak and often insufficient [1,2,3,4,5]. In the last decade, the focus of respiratory care in the delivery room has shifted from intubation and mechanical ventilation toward non-invasive ventilation and supporting spontaneous breathing [2, 6]. Both local and international resuscitation guidelines recommend to assess respiratory effort, and if necessary, stimulate and support spontaneous breathing [7,8,9]. Tactile stimulation (warming, drying, and rubbing the back or the soles of the feet) has been recommended in the guidelines to stimulate spontaneous breathing [7,8,9]. We evaluated the occurrence and patterns of tactile stimulation during stabilization of preterm infants at birth
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
