title: Nasopharyngeal suctioning does not produce a salivary cortisol reaction in preterm infants.
abstract: OBJECTIVE
  To investigate whether nasopharyngeal suctioning produces a physiological and behavioural stress reaction in preterm infants and if a possible reaction can be dampened by sweet solution.
  
  
  METHODS
  Eleven preterm infants were randomly assigned to receive either 30% oral glucose or nothing prior to morning nasopharyngeal suctioning; the procedure was reversed in the afternoon. The study included a total of 44 samples from preterm infants evaluated with salivary cortisol, pain score (Visual Analogue Scale), heart rate, oxygen saturation and recovery time through the Newborn Individualized Developmental Care and Assessment Program. For reference, 44 samples from eleven full-term infants were evaluated for salivary cortisol.
  
  
  RESULTS
  Regardless of whether or not preterm infants received glucose before nasopharyngeal suctioning, no statistically significant difference was found in salivary cortisol reactivity, pain score, heart rate, oxygen saturation or recovery time. Nor were any statistically significant differences between salivary cortisol baseline and response values found in full-term infants after nasopharyngeal suctioning.
  
  
  CONCLUSIONS
  In the present setting, nasopharyngeal suctioning was not stressful enough to increase salivary cortisol or pain score. Oral glucose did not alter salivary cortisol levels.
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden. katrin.ivars@liu.se
authors.forename: Katrin
authors.initials: K
authors.lastname: Ivars
authors.forename: Nina
authors.initials: N
authors.lastname: Nelson
authors.forename: Orvar
authors.initials: O
authors.lastname: Finnström
authors.forename: Evalotte
authors.initials: E
authors.lastname: Mörelius
mesh_terms: D000284:Administration, Oral; D045422:Continuous Positive Airway Pressure; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007224:Infant Care / Q000523:psychology*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009305:Nasopharynx; D010147:Pain Measurement; D012463:Saliva / Q000737:chemistry*; D013315:Stress, Psychological; D013396:Suction / Q000009:adverse effects / Q000523:psychology; D013549:Sweetening Agents / Q000008:administration & dosage
chemical_list: D013549:Sweetening Agents; D005947:Glucose; D006854:Hydrocortisone