Developmental patterns of physiological response to a multisensory intervention in extremely premature and high-risk infants.
OBJECTIVE
To compare the developmental patterns of heart rate (HR), respiratory rate (RR), and hemoglobin oxygen saturation (SaO2) of premature infants with and without central nervous system (CNS) injury, and evaluate whether a multisensory intervention altered this development.


METHODS
Thirty-seven premature infants born at 23-26 weeks with normal head ultrasounds or at 24-32 weeks and diagnosed with periventricular leukomalacia (PVL) and/or intraventricular hemorrhage (IVH) were studied at 33-35 weeks postconceptional age.


METHODS
Infants were randomly assigned to control and experimental groups. The experimental group infants received auditory, tactile, visual, and vestibular (ATVV) multisensory intervention twice daily from 33 weeks postconceptional age (PCA) until hospital discharge.


METHODS
HR, RR, and SaO2 were continuously monitored during baseline, intervention, and the 30-minute postintervention period.


RESULTS
Between 33 and 35 weeks PCA, control group infants with and without CNS injury and experimental group infants without CNS injury had a significant decrease in resting mean HR, whereas RR and SaO2 remained stable. The infants with PVL who received the intervention showed increases in HR even at rest.


CONCLUSIONS
The absence of a weekly decline in HR for experimental group infants with PVL suggests that PVL may affect maturation of the autonomic nervous system and increase risk of decelerative HR changes and associated clinical compromise. Infants diagnosed with PVL should be closely monitored during procedures or interventions that may be stressful or involve handling. Further research is needed to tailor multisensory interventions for infants with PVL.
White-Traut
Rosemary C
RC
University of Illinois at Chicago, College of Nursing, Department of Maternal-Child Nursing, 60612, USA.
Nelson
Michael N
MN
Silvestri
Jean M
JM
Patel
Minu
M
Berbaum
Michael
M
Gu
Guo-Guang
GG
Rey
Patricia Meleedy
PM
D000161:Acoustic Stimulation / Q000379:methods; D002543:Cerebral Hemorrhage / Q000451:nursing / Q000534:rehabilitation; D002552:Cerebral Ventricles; D002657:Child Development; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal; D007969:Leukomalacia, Periventricular / Q000451:nursing / Q000534:rehabilitation; D008297:Male; D019957:Motor Skills Disorders / Q000209:etiology / Q000517:prevention & control; D017283:Neonatal Nursing / Q000379:methods; D010101:Oxygen Consumption; D010775:Photic Stimulation / Q000379:methods; D010812:Physical Stimulation / Q000379:methods; D012684:Sensory Thresholds; D013997:Time Factors; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth