1
|
Bozdag F, Balci S. The Effects of a Three-Stair Positioning Pillow Used for Preterm Infants on Physiologic Parameters and Sleep-Wakefulness Status: Randomized Controlled Trial. J Perinat Neonatal Nurs 2024:00005237-990000000-00057. [PMID: 39374267 DOI: 10.1097/jpn.0000000000000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]
Abstract
BACKGROUND It is important to provide the necessary sleep for the growth of preterm infants in the neonatal intensive care unit. The purpose of this study was to determine the effect of 3-stair positioning pillows (TSPPs) developed for preterm infants with postnatal age 28 to 35 weeks on physiologic parameters and sleep-wakefulness status. METHODS This research was conducted as a randomized controlled experimental study. The CONSORT flowchart was used in the implementation of the randomized controlled trial. The preterm infants in the experimental group were placed in the prone position with TSPPs, whereas the preterm infants in the control group were followed in the routine prone position given in the neonatal intensive care unit. Preterm infants were followed for a total of 3 hours. RESULTS The sample of the study consisted of 60 preterm infants (experiment group = 30; control group = 30) who were hospitalized in the neonatal intensive care unit and met the selection criteria. Compared with the infants in the control group, the preterm infants in the experimental group were determined to have significantly lower heart rates, higher oxygen saturations, lower respiratory rates, longer sleep durations, and shorter wakefulness times (P < .001). CONCLUSION It was found that positioning preterm infants using TSPP had positive effects on physiological parameters (heart rate, oxygen saturation, and respiratory rate) and sleep-wakefulness status in favor of the experimental group. IMPLICATIONS FOR PRACTICE It is recommended to use a TSPP that supports the prone position to improve the physiologic parameters and sleep-wakefulness status of preterm infants in the neonatal intensive care unit. Larger studies need to be conducted utilizing longer follow-up protocols. Examining the effectiveness of TSPPs with different positioning materials in preterm infants is needed.
Collapse
Affiliation(s)
- Fatma Bozdag
- Author Affiliations: Department of Child Health and Diseases Nursing, Health Sciences of Faculty, Harran University, Sanlıurfa, Turkey (Dr Bozdag); and Department of Child Health and Diseases Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, İstanbul, Turkey (Dr Balci)
| | | |
Collapse
|
2
|
Ghazi MA, Zhou J, Havens KL, Smith BA. Accelerometer Thresholds for Estimating Physical Activity Intensity Levels in Infants: A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4436. [PMID: 39065833 PMCID: PMC11280506 DOI: 10.3390/s24144436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/18/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
Lack of physical activity (PA) at a young age can result in health issues. Thus, monitoring PA is important. Wearable accelerometers are the preferred tool to monitor PA in children. Validated thresholds are used to classify activity intensity levels, e.g., sedentary, light, and moderate-to-vigorous, in ambulatory children. No previous work has developed accelerometer thresholds for infancy (pre-ambulatory children). Therefore, this work aims to develop accelerometer thresholds for PA intensity levels in pre-ambulatory infants. Infants (n = 10) were placed in a supine position and allowed free movement. Their movements were synchronously captured using video cameras and accelerometers worn on each ankle. The video data were labeled by activity intensity level (sedentary, light, and moderate-to-vigorous) in two-second epochs using observational rating (gold standard). Accelerometer thresholds were developed for acceleration and jerk using two optimization approaches. Four sets of thresholds were developed for dual (two ankles) and for single-worn (one ankle) accelerometers. Of these, for a typical use case, we recommend using acceleration-based thresholds of 1.00 m/s to distinguish sedentary and light activity and 2.60 m/s to distinguish light and moderate-to-vigorous activity. Acceleration and jerk are both suitable for measuring PA.
Collapse
Affiliation(s)
- Mustafa A. Ghazi
- Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
| | - Judy Zhou
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Kathryn L. Havens
- Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Beth A. Smith
- Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
- Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| |
Collapse
|
3
|
Suna Dağ Y, Yayan EH. The effect of facilitated tucking and white noise on stress and sleep of newborns receiving nasal continuous positive airway pressure. J Pediatr Nurs 2024; 77:e442-e449. [PMID: 38729891 DOI: 10.1016/j.pedn.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To investigate the effects of facilitated tucking and white noise on stress and sleep in neonates receiving nasal continuous positive airway pressure (CPAP). METHOD This study was conducted as a randomised controlled experimental study of neonates receiving nasal CPAP in neonatal intensive care units. The study sample consisted of 108 newborns (facilitated tucking (n = 36), white noise (n = 36) and control (n = 36)) receiving nasal CPAP support in the NICU. The neonates' sleep parameters were recorded by actigraphy for 24 h. Data were collected using the Neonatal Descriptive Information Form, the Sleep Tracking Form and the Neonatal Stress Scale. Percentage, mean, chi-squared and one-way ANOVA were used for data analysis. RESULTS It was found that 50.9% of the newborns were female, their mean gestational age was 33.54 ± 3.38, their mean height was 43.56 ± 5.12, and their mean weight was 2139.23 ± 827.82. The total sleep time of the neonates in the facilitated tucking and white noise group increased by 3 h, their sleep efficiency increased by 20% and their mean stress scores decreased (p < 0.05). CONCLUSION Facilitated tucking and white noise each showed a similar improvement in sleep duration and sleep efficiency and a reduction in stress scores in neonates receiving nasal CPAP. Close monitoring of sleep in this population and supportive care practices are recommended. PRACTICE IMPLICATIONS The findings of this study may help to reduce sleep problems and stress levels in the clinical care of neonates in the NICU through developmental nursing practices.
Collapse
Affiliation(s)
- Yeliz Suna Dağ
- Fırat University, Faculty of Health Sciences, Child Health and Diseases Nursing, Turkey.
| | - Emriye Hilal Yayan
- Inonu University, Faculty of Nursing, Child Health and Diseases Nursing, Turkey.
| |
Collapse
|
4
|
Huang D, Yu D, Zeng Y, Song X, Pan L, He J, Ren L, Yang J, Lu H, Wang W. Generalized Camera-Based Infant Sleep-Wake Monitoring in NICUs: A Multi-Center Clinical Trial. IEEE J Biomed Health Inform 2024; 28:3015-3028. [PMID: 38446652 DOI: 10.1109/jbhi.2024.3371687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
The infant sleep-wake behavior is an essential indicator of physiological and neurological system maturity, the circadian transition of which is important for evaluating the recovery of preterm infants from inadequate physiological function and cognitive disorders. Recently, camera-based infant sleep-wake monitoring has been investigated, but the challenges of generalization caused by variance in infants and clinical environments are not addressed for this application. In this paper, we conducted a multi-center clinical trial at four hospitals to improve the generalization of camera-based infant sleep-wake monitoring. Using the face videos of 64 term and 39 preterm infants recorded in NICUs, we proposed a novel sleep-wake classification strategy, called consistent deep representation constraint (CDRC), that forces the convolutional neural network (CNN) to make consistent predictions for the samples from different conditions but with the same label, to address the variances caused by infants and environments. The clinical validation shows that by using CDRC, all CNN backbones obtain over 85% accuracy, sensitivity, and specificity in both the cross-age and cross-environment experiments, improving the ones without CDRC by almost 15% in all metrics. This demonstrates that by improving the consistency of the deep representation of samples with the same state, we can significantly improve the generalization of infant sleep-wake classification.
Collapse
|
5
|
Deveci MF, Dag YS, Alagoz M, Yasar S, Yayan EH, Gokce IK, Ozdemir R. Comparison of two different Nasal Interfaces used in Non-Invasive Respiratory support in terms of Neonate comfort. Malawi Med J 2024; 36:43-47. [PMID: 39086367 PMCID: PMC11287807 DOI: 10.4314/mmj.v36i1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Background Non-Invasive Ventilation (NIV) is the first choice approach in neonates with sufficient respiratory effort that require respiratory support. The type of nasal interface used in NIV affects both efficacy and patient comfort. The aim of this study is to investigate the effects of different nasal interfaces used in NIV support on neonatal patient comfort. Methods Our study evaluated patients who received NIV support for 24 hours. The patients were randomly divided into two groups according to the type of nasal interface used, which were RAM cannula and short binasal prong (SBP). The patients' demographic and clinical data were noted. Their sleep was monitored for 24 hours with an actigraphy device. Results A total of 82 patients were evaluated. The sleep efficiency in the RAM cannula group was significantly higher (respectively, 65.7% [10.22-95.25] vs. 57.81% [2.49-77], p=0.004). Although not statistically significant, the neonates in the RAM cannula group exhibited longer total sleep time (respectively, 10.4 ± 4.28 hours vs. 9.02 ± 3.73 hours, p=0.161). Comparison of heart rates and respiratory rates indicate that the patients in the RAM cannula group were more comfortable. Conclusions Our study found that infants who received NIV support through a RAM cannula experienced more efficient sleep. Holistic approaches in neonatal intensive care units are vital for better neurodevelopmental outcomes in newborns. Although non-invasive, the interface used in NIV should also be a part of this holistic approach.
Collapse
Affiliation(s)
- Mehmet Fatih Deveci
- Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey
| | - Yeliz Suna Dag
- Department of Child Health Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Meral Alagoz
- Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey
| | - Seyma Yasar
- Department of Biostatistics and Medical Informatics, Inonu University School of Medicine, Malatya, Turkey
| | - Emriye Hilal Yayan
- Department of Child Health Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Ismail Kursad Gokce
- Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey
| | - Ramazan Ozdemir
- Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey
| |
Collapse
|
6
|
Ülgen Ö, Barış HE, Aşkan ÖÖ, Akdere SK, Ilgın C, Özdemir H, Bekiroğlu N, Gücüyener K, Özek E, Boran P. Sleep assessment in preterm infants: Use of actigraphy and aEEG. Sleep Med 2023; 101:260-268. [PMID: 36459917 DOI: 10.1016/j.sleep.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Objective methods to monitor the sleep of preterm infants at the neonatal intensive care unit (NICU) are required to prevent potentially adverse neurodevelopmental outcomes. This study aimed to determine the concordance of actigraphy and amplitude-integrated electroencephalogram (aEEG) against gold standard direct observation (DO) in assessing sleep/wake states of typically developing preterm infants. METHODS This prospective observational study was conducted in a single center level III NICU. Sleep variables were measured using Philips Respironics Mini-Mitter® Actiwatch-2 for 24 h and compared with 8-h matched data of aEEG and DO. Sensitivity-specificity analysis, Cohen's kappa, prevalence-adjusted and bias-adjusted kappa (PABAK), and Bland Altman plots were generated. RESULTS Seventeen preterm infants were recruited. A total of 11252 epochs were studied. Sensitivity (86.4%), agreement rate (67.9%), and predictive value for wake (47.9%) for the actigraphy were highest at the automatic activity threshold whereas specificity (54.5%) and predictive value for sleep (75.5%) were highest at low threshold. The sensitivity of aEEG was 79.3% and the specificity was 54.3%. At all thresholds, the agreement was largely equivalent with low kappas (0.14-0.17) and PABAK coefficients (0.22-0.35) for actigraphy and DO. Moderate agreement was observed between aEEG and DO according to the PABAK coefficient (0.44). Mean differences in sleep parameters were not different between DO and aEEG as well as DO/aEEG and actigraphy at medium threshold (p > 0.05). CONCLUSIONS Actigraphy at medium threshold can be used in depicting sleep in typically developing preterm infants at NICU. aEEG may be an alternative adjunctive method to actigraphy for the evaluation of sleep/wake states in the NICU setting. CLINICAL TRIAL REGISTRATION NUMBER NCT04145362.
Collapse
Affiliation(s)
- Özge Ülgen
- Marmara University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey
| | - Hatice Ezgi Barış
- Marmara University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey
| | - Öykü Özbörü Aşkan
- Marmara University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey
| | - Selda Küçük Akdere
- Marmara University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey
| | - Can Ilgın
- Marmara University, School of Medicine, Division of Public Health, Istanbul, Turkey
| | - Hülya Özdemir
- Marmara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Nural Bekiroğlu
- Marmara University, School of Medicine, Department of Biostatistics, Istanbul, Turkey
| | - Kıvılcım Gücüyener
- Gazi University, School of Medicine, Division of Pediatric Neurology, Ankara, Turkey
| | - Eren Özek
- Marmara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Perran Boran
- Marmara University, School of Medicine, Department of Pediatrics, Division of Social Pediatrics, Istanbul, Turkey.
| |
Collapse
|
7
|
Giurgiu M, Kolb S, Nigg C, Burchartz A, Timm I, Becker M, Rulf E, Doster AK, Koch E, Bussmann JBJ, Nigg C, Ebner-Priemer UW, Woll A. Assessment of 24-hour physical behaviour in children and adolescents via wearables: a systematic review of free-living validation studies. BMJ Open Sport Exerc Med 2022; 8:e001267. [PMID: 35646389 PMCID: PMC9109110 DOI: 10.1136/bmjsem-2021-001267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Studies that assess all three dimensions of the integrative 24-hour physical behaviour (PB) construct, namely, intensity, posture/activity type and biological state, are on the rise. However, reviews on validation studies that cover intensity, posture/activity type and biological state assessed via wearables are missing. Design Systematic review. The risk of bias was evaluated by using the QUADAS-2 tool with nine signalling questions separated into four domains (ie, patient selection/study design, index measure, criterion measure, flow and time). Data sources Peer-reviewed validation studies from electronic databases as well as backward and forward citation searches (1970–July 2021). Eligibility criteria for selecting studies Wearable validation studies with children and adolescents (age <18 years). Required indicators: (1) study protocol must include real-life conditions; (2) validated device outcome must belong to one dimension of the 24-hour PB construct; (3) the study protocol must include a criterion measure; (4) study results must be published in peer-reviewed English language journals. Results Out of 13 285 unique search results, 76 articles with 51 different wearables were included and reviewed. Most studies (68.4%) validated an intensity measure outcome such as energy expenditure, but only 15.9% of studies validated biological state outcomes, while 15.8% of studies validated posture/activity type outcomes. We identified six wearables that had been used to validate outcomes from two different dimensions and only two wearables (ie, ActiGraph GT1M and ActiGraph GT3X+) that validated outcomes from all three dimensions. The percentage of studies meeting a given quality criterion ranged from 44.7% to 92.1%. Only 18 studies were classified as ‘low risk’ or ‘some concerns’. Summary Validation studies on biological state and posture/activity outcomes are rare in children and adolescents. Most studies did not meet published quality principles. Standardised protocols embedded in a validation framework are needed. PROSPERO registration number CRD42021230894.
Collapse
Affiliation(s)
- Marco Giurgiu
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - Simon Kolb
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Carina Nigg
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Sport Pedagogy, University of Bern, Bern, Switzerland
| | - Alexander Burchartz
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Irina Timm
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Marlissa Becker
- Department of Orthopedics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ellen Rulf
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ann-Kathrin Doster
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Elena Koch
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine and Physical Therapy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Claudio Nigg
- Department of Health Science, University of Bern, Bern, Switzerland
| | - Ulrich W Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.,Department of Sports and Sports Science, Institute of Sports and Sports Science, Karlsruhe, Germany
| | - Alexander Woll
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| |
Collapse
|