Vincent C Smith1, Damian Kelty-Stephen2, Mona Qureshi Ahmad3, Wenyang Mao4, Kelly Cakert3, John Osborne5, David Paydarfar6. 1. Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; vsmith1@bidmc.harvard.edu. 2. Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; Grinnell College, Grinnell, Iowa; and. 3. Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; 4. Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; 5. Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; 6. Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts; Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts.
Abstract
OBJECTIVE: To evaluate the effect of stochastic resonance (SR) stimulation on preterm infant oxygen desaturation, bradycardia, and apnea events. We hypothesized that SR stimulation will reduce these events. METHODS: This was a randomized crossover study conducted from April 2012 to July 2014. Eligible preterm infants were not receiving ventilation support and had at least 1 clinically documented apnea, bradycardia, and/or oxygen desaturation event. The 3 outcome variables were as follows: oxygen desaturation, bradycardia, and apnea events. Infants received up to two 3- or 4-hour intervention periods of 30-minute alternating intervals of SR stimulation and no SR stimulation. The first intervention period was randomly assigned to begin with SR stimulation either on or off, whereas the next intervention period automatically began with the opposite on/off state. We compared the SR stimulation "on" periods with the SR stimulation "off" periods with each infant serving as his or her own control. RESULTS: The sample consisted of 36 infants with a mean (±SD) gestational age of 30.5 ± 3 weeks and a birth weight of 1409 ± 450 g. SR stimulation decreased the number of apneic events by 50%. SR stimulation ameliorated every aspect of clinically significant oxygen desaturation events, with a 20% to 35% decrease in the number, duration, and intensity of oxygen desaturation events when SR stimulation was on. Also, SR stimulation produced a nearly 20% reduction in the intensity of bradycardia events. CONCLUSIONS:SR stimulation may be a noninvasive and nonpharmacologic treatment option for apnea, oxygen desaturation, and some aspects of bradycardia in premature infants.
RCT Entities:
OBJECTIVE: To evaluate the effect of stochastic resonance (SR) stimulation on preterm infantoxygen desaturation, bradycardia, and apnea events. We hypothesized that SR stimulation will reduce these events. METHODS: This was a randomized crossover study conducted from April 2012 to July 2014. Eligible preterm infants were not receiving ventilation support and had at least 1 clinically documented apnea, bradycardia, and/or oxygen desaturation event. The 3 outcome variables were as follows: oxygen desaturation, bradycardia, and apnea events. Infants received up to two 3- or 4-hour intervention periods of 30-minute alternating intervals of SR stimulation and no SR stimulation. The first intervention period was randomly assigned to begin with SR stimulation either on or off, whereas the next intervention period automatically began with the opposite on/off state. We compared the SR stimulation "on" periods with the SR stimulation "off" periods with each infant serving as his or her own control. RESULTS: The sample consisted of 36 infants with a mean (±SD) gestational age of 30.5 ± 3 weeks and a birth weight of 1409 ± 450 g. SR stimulation decreased the number of apneic events by 50%. SR stimulation ameliorated every aspect of clinically significant oxygen desaturation events, with a 20% to 35% decrease in the number, duration, and intensity of oxygen desaturation events when SR stimulation was on. Also, SR stimulation produced a nearly 20% reduction in the intensity of bradycardia events. CONCLUSIONS:SR stimulation may be a noninvasive and nonpharmacologic treatment option for apnea, oxygen desaturation, and some aspects of bradycardia in premature infants.
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