A preliminary study of bottom care effects on premature infants' heart rate and oxygen saturation.

The purposes of this study were to explore (1) the effect of buttock care (BC) on premature infant heart rate (HR) and oxygen saturation (SpO(2)), and (2) the effect of buttock lifting angle during BCs on HR and SpO(2). The study used a repeated measure design. A convenience sample of 11 premature infants in the neonatal intensive care unit (NICU) of a medical center were studied during 30 BC events. The subjects were of a gestational age of less than and 37 weeks, and postnatal age of less than one month, without known congenital abnormalities and without having been treated with sedatives during the study. Infant HR and SpO(2) were measured at a 30-second interval 10 minutes before and during, and 15 minutes after BC. Maximal lifting angles of BCs during the procedure were recorded. Based on the infant's individual responses to BC, 63.3% of BCs induced an increase in HR and a decrease in SpO(2), defined as the change in HR and SpO(2) greater than two standard deviations from the baseline. In addition, 30% of BCs resulted in cardiac decelerations. The extent of the difference found in these change patterns in HR or SpO(2) were all significant (p <.01) and their mean recovery times were longer than 10 minutes. More HR acceleration events occurred as the BC lifting angle exceeded </= 30 degrees, and more HR deceleration events were found as the angle > 30 degrees (p =.035). Buttock care can have a significant impact on premature infant physiological stability. The BC lifting angle may play an important role in HR acceleration or deceleration. Careful observation before and after BC for premature infants is recommended.