A Randomized Controlled Trial of the Use of Oral Glucose with or without Gentle Facilitated Tucking of Infants during Neonatal Echocardiography.
OBJECTIVE
To compare the effect of oral glucose given with or without facilitated tucking (FT), versus placebo (water) to facilitate image acquisition during a targeted neonatal echocardiography (TNE).


METHODS
Factorial, double blind, randomized controlled trial.


METHODS
Tertiary neonatal intensive care unit (NICU).


METHODS
Infants born between 26 and 42 weeks of gestation (GA).


METHODS
One of four treatment groups: oral water (placebo), oral glucose (25%), facilitated tucking with oral water or facilitated tucking with oral glucose, during a single, structured TNE. All infants received a soother.


METHODS
Change in Behavioral Indicators of Infant Pain (BIIP) scores.


RESULTS
104 preterm infants were randomized (mean ± SD GA: 33.4 ± 3.5 weeks). BIIP scores remained low during the echocardiography scan (median, [IQ range]: 0, [0 to 1]). There were no differences in the level of agitation of infants amongst the treatment groups, with estimated reductions in mean BIIP relative to control of 0.27 (95%CI -0.40 to 0.94) with use of oral glucose and .04 (-0.63 to 0.70) with facilitated tucking. There were also no differences between treatment groups in the quality and duration of the echocardiography scans.


CONCLUSIONS
In stable infants in the NICU, a TNE can be performed with minimal disruption in a majority of cases, simply by providing a soother. The use of 25% glucose water in this context did not provide further benefit in reducing agitation and improving image acquisition.


BACKGROUND
Clinical Trials.gov: NCT01253889.
Children's & Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada; Child & Family Research Institute, Vancouver, Canada.
Pascal M
PM
Lavoie
Children's & Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada.
Amelie
A
Stritzke
Children's & Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada; Child & Family Research Institute, Vancouver, Canada.
Joseph
J
Ting
Children's & Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada.
Mohammad
M
Jabr
Department of Pediatrics/Division of Neonatology, University of Toronto, Ontario, Canada.
Amish
A
Jain
Department of Pharmacy, Children's & Women's Health Centre of British Columbia, Vancouver, Canada.
Eddie
E
Kwan
Children's & Women's Health Centre of British Columbia, Vancouver, Canada.
Ela
E
Chakkarapani
Children's & Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics/Division of Cardiology, University of British Columbia, Vancouver, Canada.
Paul
P
Brooks
Child & Family Research Institute, Vancouver, Canada; Department of Statistics, University of British Columbia, Vancouver, Canada.
Rollin
R
Brant
Department of Pediatrics/Division of Neonatology, University of Toronto, Ontario, Canada.
Patrick J
PJ
McNamara
Child & Family Research Institute, Vancouver, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.
Liisa
L
Holsti
D004311:Double-Blind Method; D004452:Echocardiography / Q000451:nursing / Q000523:psychology*; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control*; D010147:Pain Measurement; D011595:Psychomotor Agitation / Q000503:physiopathology / Q000517:prevention & control*
D005947:Glucose