Thoyre Suzanne M, Carlson John R
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7460, USA.
J Adv Nurs. 2003 Sep;43(6):631-41. doi: 10.1046/j.1365-2648.2003.02762.x.
During the time when preterm infants' oral feeding skills are developing they often experience physiological instability and need assistance from caregivers to maintain adequate oxygenation. Assisting infants to maintain optimal oxygenation during oral feeding requires an understanding of how they express and aim to self-regulate their oxygen status.
The purpose of this study was to identify potential behavioural indicators of declining oxygenation during preterm infant early bottle-feeding.
The design was explorative. Data were collected from a secondary analysis of 20 videotapes of preterm infant bottle feedings which included concurrent oxygen saturation data. In this analysis infant behaviours and quality of breathing were coded and compared across three periods: high oxygen saturation, immediately preceding an oxygen desaturation event, and during an oxygen desaturation event.
Infants gave limited behavioural indicators of declining oxygenation. Immediately prior to a desaturation event, they had an increase in eye flutter and were typically sucking and apnoeic. During a desaturation event, they typically relaxed their arms/hands and stopped sucking.
Reliance on preterm infant behavioural cues will be insufficient for detection of oxygen desaturation during oral feeding. Attention to changes in breath sounds and to the pattern of sucking are potentially important intervention strategies for the prevention of and appropriate response to oxygen decline during feeding. Sucking pauses may be a time when preterm infants aim to regulate their breathing pattern and thereby increase oxygenation. Interventions that focus on detection and minimization of apnoea during feeding, and which aim to protect infant sucking pauses, may reduce the number and severity of desaturation events preterm infants experience during bottle feeding.
在早产儿口腔喂养技能发展期间，他们常常经历生理不稳定，需要照料者的协助以维持充足的氧合作用。在口腔喂养期间协助婴儿维持最佳氧合作用需要了解他们如何表达并旨在自我调节其氧状态。
本研究的目的是确定早产儿早期奶瓶喂养期间氧合作用下降的潜在行为指标。
设计为探索性的。数据收集自对20段早产儿奶瓶喂养录像带的二次分析，这些录像带包含同步的血氧饱和度数据。在该分析中，对婴儿行为和呼吸质量进行编码，并在三个时间段进行比较：高血氧饱和度、氧饱和度下降事件即将发生前以及氧饱和度下降事件期间。
婴儿给出的氧合作用下降的行为指标有限。在饱和度下降事件即将发生前，他们的眼球颤动增加，通常正在吸吮且呼吸暂停。在饱和度下降事件期间，他们通常会放松手臂/手部并停止吸吮。
依靠早产儿的行为线索不足以在口腔喂养期间检测到氧饱和度下降。关注呼吸音的变化和吸吮模式可能是预防喂养期间氧含量下降并做出适当反应的重要干预策略。吸吮暂停可能是早产儿旨在调节其呼吸模式从而增加氧合作用的时期。专注于检测并尽量减少喂养期间呼吸暂停并旨在保护婴儿吸吮暂停的干预措施可能会减少早产儿在奶瓶喂养期间经历的饱和度下降事件的数量和严重程度。
