Janneke Dekker1, Stuart B Hooper2, Tessa Martherus3, Sophie J E Cramer4, Nan van Geloven5, Arjan B Te Pas3. 1. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: j.dekker@lumc.nl. 2. The Ritchie Center, MIMR-PHI Institute of Medical Research, Melbourne, Australia. 3. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands. 4. Department of Instrumental Affairs, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Medical Statistics and Bio-informatics, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
AIM: To evaluate the direct effect of repetitive tactile stimulation on breathing effort of preterm infants at birth. METHODS: This randomized controlled trial compared the effect of repetitive stimulation on respiratory effort during the first 4 min after birth with standard stimulation based on clinical indication in preterm infants with a gestational age of 27-32 weeks. All details of the stimulation performed were noted. The main study parameter measured was respiratory minute volume, other study parameters assessed measures of respiratory effort; tidal volumes, rate of rise to maximum tidal volumes, percentage of recruitment breaths, and oxygenation of the infant. RESULTS: There was no significant difference in respiratory minute volume in the repetitive stimulation group when compared to the standard group. Oxygen saturation was significantly higher (87.6 ± 3.3% vs 81.7 ± 8.7%, p = .01) while the amount of FiO2 given during transport to the NICU was lower (28.2 (22.8-35.0)% vs 33.6 (29.4-44.1)%, p = .04). There was no significant difference in administration of positive pressure ventilation (52% vs 78%, p = .13), or the duration of ventilation (median (IQR) time 8 (0-118)s vs 35 (13-131)s, p = .23). Caregivers decided less often to administer caffeine in the delivery room to stimulate breathing in the repetitive stimulation group (10% vs 39%, p = .036). CONCLUSION: Although the increase in respiratory effort during repetitive stimulation did not reach significance, oxygenation significantly improved with a lower level of FiO2 at transport to the NICU. Repetitive tactile stimulation could be of added value to improve breathing effort at birth.
RCT Entities:
AIM: To evaluate the direct effect of repetitive tactile stimulation on breathing effort of preterm infants at birth. METHODS: This randomized controlled trial compared the effect of repetitive stimulation on respiratory effort during the first 4 min after birth with standard stimulation based on clinical indication in preterm infants with a gestational age of 27-32 weeks. All details of the stimulation performed were noted. The main study parameter measured was respiratory minute volume, other study parameters assessed measures of respiratory effort; tidal volumes, rate of rise to maximum tidal volumes, percentage of recruitment breaths, and oxygenation of the infant. RESULTS: There was no significant difference in respiratory minute volume in the repetitive stimulation group when compared to the standard group. Oxygen saturation was significantly higher (87.6 ± 3.3% vs 81.7 ± 8.7%, p = .01) while the amount of FiO2 given during transport to the NICU was lower (28.2 (22.8-35.0)% vs 33.6 (29.4-44.1)%, p = .04). There was no significant difference in administration of positive pressure ventilation (52% vs 78%, p = .13), or the duration of ventilation (median (IQR) time 8 (0-118)s vs 35 (13-131)s, p = .23). Caregivers decided less often to administer caffeine in the delivery room to stimulate breathing in the repetitive stimulation group (10% vs 39%, p = .036). CONCLUSION: Although the increase in respiratory effort during repetitive stimulation did not reach significance, oxygenation significantly improved with a lower level of FiO2 at transport to the NICU. Repetitive tactile stimulation could be of added value to improve breathing effort at birth.
Authors: Janneke Dekker; Anton H van Kaam; Charles C Roehr; Andreas W Flemmer; Elizabeth E Foglia; Stuart B Hooper; Arjan B Te Pas Journal: Pediatr Res Date: 2019-06-19 Impact factor: 3.756
Authors: Janneke Dekker; Stuart B Hooper; Michelle K Croughan; Kelly J Crossley; Megan J Wallace; Erin V McGillick; Philip L J DeKoninck; Marta Thio; Tessa Martherus; Gary Ruben; Charles C Roehr; Sophie J E Cramer; Andreas W Flemmer; Linda Croton; Arjan B Te Pas; Marcus J Kitchen Journal: Front Pediatr Date: 2019-10-22 Impact factor: 3.418
Authors: Janneke Dekker; Tessa Martherus; Enrico Lopriore; Martin Giera; Erin V McGillick; Jeroen Hutten; Ruud W van Leuteren; Anton H van Kaam; Stuart B Hooper; Arjan B Te Pas Journal: Front Pediatr Date: 2019-12-12 Impact factor: 3.418
Authors: Tessa Martherus; Kelly J Crossley; Karyn A Rodgers; Janneke Dekker; Anja Demel; Alison M Moxham; Valerie A Zahra; Graeme R Polglase; Calum T Roberts; Arjan B Te Pas; Stuart B Hooper Journal: Front Pediatr Date: 2021-01-22 Impact factor: 3.418
Authors: Ruud W van Leuteren; Anouk W J Scholten; Janneke Dekker; Tessa Martherus; Frans H de Jongh; Anton H van Kaam; Arjan B Te Pas; Jeroen Hutten Journal: Front Pediatr Date: 2021-02-09 Impact factor: 3.418
Authors: John Madar; Charles C Roehr; Sean Ainsworth; Hege Ersda; Colin Morley; Mario Rüdiger; Christiane Skåre; Tomasz Szczapa; Arjan Te Pas; Daniele Trevisanuto; Berndt Urlesberger; Dominic Wilkinson; Jonathan P Wyllie Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.892
Authors: Arjan B Te Pas; Stuart B Hooper; Tessa Martherus; Michelle K Croughan; Kelly J Crossley; Megan J Wallace; Erin V McGillick; Marta Thio; Charles C Roehr; James T Pearson; Katie Lee; Gary Ruben; Marcus J Kitchen Journal: Pediatr Res Date: 2021-07-22 Impact factor: 3.953
Authors: Sophie J E Cramer; Henriëtte Anje van Zanten; Manon Boezaard; Petronella M Hoek; Janneke Dekker; Stuart B Hooper; Arjan B Te Pas Journal: Acta Paediatr Date: 2020-09-22 Impact factor: 2.299