Author(s): Lima, Cintia Raquel de
Date: 2020
Origin: Oasisbr
Subject(s): Tratamento intensivo neonatal; Neonatologia; Posicionamento Hammock; Rec??m-nascidos pr??-termo; Triagem neonatal; CI??NCIAS DA SA??DE; Rec??m-Nascido Prematuro; Posicionamento do Paciente; Unidades de Terapia Intensiva Neonatal; Modalidade de Fisioterapia
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Funda????o de Amparo ?? Pesquisa do Estado do Amazonas - FAPEAM
Introduction: The Hammock positioning was used by Brazilian health professionals as a practice of humanized care in preterm newboRN (PTNB) in Neonatal Intensive Care Units (NICU). It is awarded for contributing to the improvement of the vestibular system, sensory integration, balance and proprioception, unwanted changes or retractions and promotion of tonic and behavioral reorganization. However, there is little scientific research on the topic. Objective: to analyze how neurobehavioral and cardiorespiratory repercussions of Hammock positioning in PTNBs in NICUs. Method: observational, prospective and analytical cohort study.As neurobehavioral variables using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS), Neonatal Infant Pain Scale (NIPS), Neonatal Facial Coding System Scale (NFCS) and PIPP: Premature Infant Pain Profile and as variables Cardiorespiratory: respiratory rate (RF) and peripheral oxygen saturation (SpO2), were observed 5 minutes before, during (1 and 2 hours), at the last moment of positioning; and 5 and 30 minutes later. Data processing was performed using the SPSS program (Statistical Package for the Social Sciences 22). The data were presented as simple descriptive statistics (percentage -%, mean, standard deviation, median and interquartile range - IQR). As the medians were compared using the Friedman, Q Cochran and ANOVA tests for repeated measures, attributing results with p <0.05. Results: 45 PTNBs, born with gestational age between 25-35 weeks, were observed. PTNBs progressively progressed to deep sleep during network positioning (p = 0.007 Cochran's Q test). There was no significant change in pain scores (p> 0.05, Cochran's Q test). As cardiorespiratory variables kept within normal limits without changes (p> 0.05, Friedman's test and ANOVA for repeated measures). Conclusion: Hammock positioning indicates deep sleep and does not alter cardiorespiratory variables. Key words: Premature Newborn; Patient positioning; Neonatal Intensive Care Units; Physiotherapy.
Introdu????o: O posicionamento Hammock tem sido utilizado por profissionais da sa??de brasileiros como uma pr??tica da aten????o humanizada em rec??m-nascidos pr??-termo (RNPT) em Unidades de Terapia Intensiva Neonatal (UTIN). Seu uso ?? pautado na premissa de que contribua para o adequado desenvolvimento do sistema vestibular, integra????o sensorial, equil??brio e propriocep????o, evitando extens??es ou retra????es indesejadas, promovendo reorganiza????o t??nica e comportamental e levando ao relaxamento e diminui????o do estresse, favorecendo o ganho de peso em RNPT. Contudo, existem poucas evid??ncias cient??ficas sobre o tema. Objetivo: analisar as repercuss??es neurocomportamentais e cardiorrespirat??rias do posicionamento Hammock em RNPT em UTIN. M??todo: estudo de coorte observacional, prospectivo e anal??tico. As vari??veis foram observados 5 minutos antes, durante (1 e 2 horas), no ??ltimo momento do posicionamento; e 5 e 30 minutos ap??s: vari??veis neurocomportamentais por meio das escalas Brazelton Neonatal Behavioral Assessment Scale (BNBAS), Neonatal Infant Pain Scale (NIPS), Escala Neonatal Facial Coding System (NFCS) e PIPP: Premature Infant Pain Profile e as vari??veis cardiorrespirat??rias: frequ??ncia card??aca (FC), frequ??ncia respirat??ria (FR) e satura????o perif??rica de oxig??nio (SpO2). O processamento dos dados foi realizado pelo programa SPSS (Statistical Package for the Social Sciences 22) e eles foram apresentados como estat??stica descritiva simples (percentual -%, m??dia, desvio padr??o, mediana e intervalo interquartil ??? IQR). As medianas foram comparadas pelos testes de Friedman, Q Cochran e ANOVA para medidas repetidas, atribuindo-se como significativos resultados com p<0,05. Resultados: Foram observados 45 RNPT, nascidos com idade gestacional entre 25-35 semanas. Os RNPT evolu??ram progressivamente para o sono profundo durante o posicionamento Hammock (p= 0,007 teste Q de Cochran). Os RNPT n??o estavam com dor antes do posicionamento Hammock, vari??vel que n??os e alterou com o procedimento (p > 0,05, teste Q de Cochran). As vari??veis cardiorrespirat??rias mantiveram-se dentro dos limites de normalidade, tamb??m sem altera????es (p > 0,05, teste de Friedman e ANOVA para medidas repetidas). Conclus??o: O posicionamento Hammock induziu ao sono profundo e n??o alterou as vari??veis cardiorrespirat??rias.
