The Effects Of Different Postures On Cerebral Regional Oxygen Saturation And Vital Signs In Premature Infants

Objective:By comparing the cerebral regional tissue oxygensaturation and vital signs of premature infants in different recumbent position(supine,prone position)and different head elevation angles(0 °,15 °),so as toexplore the effects that different body positions bring on cerebral regional tissue oxygen saturation and vital signs in premature infants,which providing a basisfor clinical evaluation of brain tissue oxygenation,guiding clinical nurses of neonatal department to carry out effective postur e management and condition monitoring of premature infants.Methods:From July 2018 to October 2018,37 premature infants who met the inclusion and exclusion criteria in the neonatal department of traditional chinese medicine hospital affiliated to southwest medical university were selected as the research objects.Starting from thesecond day after hospitalization,the premature infants were placed in thefollowing positions every day for a week:15° prone,15° supine,0° prone,0°supine position inorder,measured t h e ce r e br a l re g i o n a l ti s s u e o x y g e n saturation(C-r SO2)and vital signs(including Heart rate(HR)、 Respiratoryrate(RR)、 Percutaneous pulse oxygen saturation(Sp O2)、Systolic bloodpressure(SBP)、Diastolic bloodpressure(DBP)、Mean arterial pressure(MAP))under the different position,and recorded the crying and sleeping time duringeach feeding cycle.From 09:00every day,every 2 to 3 hours for a feeding cycle,in each feeding cycle will be maintained in a position,until the next feeding cycle.But all the children need to be placed in the supine position duringfeeding,15° to 30°head tilted slightly to one side,15 min after the feeding on the correspondingposition,in addition to the treatment and nursing,skin care and other time,all keep the corresponding position.Results:(1)When placing all the premature infants in prone position:the cerebral regional tissue oxygen saturation at15° head elevation angle is higher than that at 0°,which means thedifference was statistically significant(P<0.05);and there was also statistically significant difference in the RR,Sp O2,SBP,MAP compareing 15° with 0°head elevation angle(P<0.05);but there was no statistically significant difference in the HR,DBP compareing 15° with 0° head elevation angle(P>0.05),and there was statistically significant difference in the crying and sleeping time for a feeding cycle compareing 15° with 0° head elevation angle(P<0.05).(2)While all in supine position: the regional cerebral oxygen saturation at 15° is higher than that at 0°,which means the difference was statistically significant(P<0.05);while there was no statistically significant difference in the HR,RR,Sp O2,SBP,DBP,MAP comparing 15° with 0° head elevation angle(P>0.05);and there was statistically significant difference in the crying and sleeping time for a feeding cycle compareing 15° with 0° head elevation angle(P <0.05).(3)When placing all of them at 15° head elevation angle:the regional cerebral oxygen saturation in prone position is higher than that in supine position,which means the difference was statistically significant(P<0.05);there was statistically significant difference in the vital signs(HR,RR,Sp O2,SBP,DBP,MAP)comparing the supine position with the prone position(P<0.05),the prone position was more stable than the supine position,so the prone position had significant advantages;there was statistically significant difference in the crying and sleeping time for a feeding cycle comparing the supine position with the prone position(P<0.05).(4)While all at 0°: there was no significant difference in regional cerebral oxygen saturation between prone and supine position,which means the difference was not statistically significant(P>0.05);there was also no statistically significant difference in the SBP,DBP and MAP comparing supine position with prone position(P>0.05);while there was statistically significant difference in the RR,Sp O2,SBP,MAP compareing 15° with 0° head elevation angle(P<0.05);there was statistically significant difference in the crying and sleeping time for a feeding cycle comparing the supine position with the prone position(P<0.05).Conclusion:15° head elevation angle is beneficial to improving regional cerebral oxygen saturation,reducing crying and promoting sleep in premature infants;while prone position is beneficial to stabilizingvital signs of premature infants.