Prevention Technology Reduces Apnea in Preterm Infants - Critical Care - Hospimedica.com

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Prevention Technology Reduces Apnea in Preterm Infants

New mattress technology based on of stochastic resonance (SR) reduces apneic events and improves critical clinical parameters in preterm infants, according to a new study.

Researchers at the Wyss Institute for Biologically Inspired Engineering (Boston, MA, USA; wyss.harvard.edu), Beth Israel Deaconess Medical Center (BIDMC; Boston, MA, USA), and the University of Massachusetts Medical School (UMMS; Worcester, USA) conducted a study to evaluate effects of SR stimulation on 36 preterm infants who received 3–4 hour sessions of alternating intervals of SR stimulation in the neonatal intensive care unit (nICU). Oxygen desaturation, bradycardia, and apnea events were monitored, with each infant serving as their own control.

SR involves the application of a small amount of random vibratory stimulation, or "noise" to a complex biological system—such as the human body—to increase the sensitivity of that system. To deliver SR to the preterm infants, the researchers developed a new therapeutic mattress device that delivers subtle vibration to the body of the infant, but limits the vibrations that would otherwise be delivered to the head to protect the developing brain from any potential undesired effects.

The results showed that SR stimulation not only halved the number of apneic events, but also improved every clinically significant parameter that characterizes oxygen desaturation events. In all, the infants experienced a 20%–35% decrease in the number, duration, and intensity of oxygen desaturation events during the 30-minute periods when SR stimulation was on, compared to the off periods. SR stimulation also produced a nearly 20% reduction in the intensity of bradycardia events. The study was published in the November 23, 2015, issue of Pediatrics.

“We saw a reduction in the incidence of apnea by 50%, and, perhaps equally important, we ameliorated every clinically significant aspect of oxygen desaturation events as well as decreased the severity of bradycardia events; these effects were in addition to any caffeine effects,” said lead author assistant professor of pediatrics Vincent Smith, MD, MPH, associate director of the BIDMC nICU. “The technology therefore might be used as a stand-alone or as a supplement to the caffeine therapy with which many preterm infants are commonly treated.”

One in nine infants is born prematurely, and many of these newborns are at higher risk for apnea of prematurity, typically characterized by prolonged pauses in breathing of at least 20 seconds each. The apneic episodes occur in more than 50% of infants born prior to 37 weeks and in almost every baby of very low birth weight. Even when life threatening events are treated, apnea can result in insufficient oxygen delivery to critical organs such as the brain, causing developmental delays and long-term cognitive deficits.

Related Links: Wyss Institute for Biologically Inspired Engineering http://wyss.harvard.edu/ Beth Israel Deaconess Medical Center http://www.bidmc.org/ University of Massachusetts Medical School http://www.umassmed.edu/

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