早產兒在口腔餵食早期之心率變異、心肺功能調節與其餵食成效的關係
作者: 張雅雯
Chang,
Ya-Wen 貢獻者: 護理學系碩博士班
張瑩如
Chang,
Ying-Ju 關鍵詞: cardiorespiratory
modulation
heart
rate variability
the
early period of oral feeding
preterm
infants
the
transitional period of oral feeding
feeding
performance
餵食成效
心肺?能調節
口腔餵食過渡期
心率變異
口腔餵食早期
早產兒
日期:
Generally premature infants start oral feeding as their postconceptional
ages reach 32 weeks because of better coordination of suck swallow and
breathing Even though some preterm infants demonstrate stress behavior and cardiorespiratory instabilities at the early period of oral
feeding The maturation of parasympathetic nerve might play an important role of
successful oral feeding However little is known what are the relationship among
vagal activity feeding performance and cardiorespiratory modulation Purposes of this study were to
(a) explore the relationships among heart rate variability (HRV) feeding
performance heart rate (HR) and oxygen saturation (SpO2) of preterm infants in
the early period of oral feeding and to (b) identify clinical indicators of
feeding performance The correlative study was used in the neonatal intensive
care unit (NICU) and sick baby room (SBR) of a Medical Center of southern
Taiwan Forty-seven premature infants participated in this study They were (a)
under 32 weeks gestational age at birth and greater than 32 weeks of postconceptional age at study (b) allowed for trying
bottle-feeding by the physician (c) without congenital anomalies and oropharynx diseases and (d) with parental consents In the
early period of oral feeding infants feeding performance and HRV HR and SpO2 of
pre during and post-feeding periods were observed Data was analyzed using
descriptive statistics repeated measure analysis of variance Pearson’s
correlation Student t-test and multiple regressions Results showed that (a) the
mean R-R interval (RRI) decreased and LF/HF ratio increased during feeding then
returned to the baseline after 5 and 20 minutes of post-feeding periods respectively
(b) HR increased and SpO2 decreased during feeding then returned to the
baseline 5 minutes after feeding (c) significantly positive relationships were
found among feeding performance and HRV of pre during and pre-to-during feeding
periods (d) no significant relationship was found among feeding performance HR
and SpO2 of pre during and post feeding periods (e) significantly negative
relationships were found between HRV and HR of pre during and pre-to-during
feeding periods Besides there was a negative relationship between HRV and SpO2
during feeding (f) pre-feeding HRV had significant relationships with HR of
during post pre-to-during and during-to-post feeding periods There was no
significant relationship among pre-feeding HRV and SpO2 of each period and (g)
the ratio of LF/HF during feeding to LF/HF of pre-feeding accounted for 84 9%
of the variance of feeding performance when indexed by the volume of
transferred milk per minute Results of the present study showed significant
relationships among HRV cardiorespiratory modulation
and feeding performance of preterm infants in the early period of oral feeding
These findings provide knowledge of specific clinical indicators of successful
oral feeding and may facilitate protocols for safe feeding of premature infants
in the future URI: http://nckur.lib.ncku.edu.tw/handle/987654321/32959