Neonatal intensive care unit (NICU) light and noise may be stressful to preterm infants. This research evaluated the physiological stability of 54 infants born at 28- to 32-weeks’ gestational age while wearing eye goggles and earmuffs for a 4-hour period in the NICU. Infants were recruited from four NICUs of university-affiliated hospitals and randomized to the intervention–control or control–intervention sequences. Heart rate (HR), heart rate variability (HRV), and oxygen saturation (O2 sat) were collected using the SomtéTM device. Confounding variables such as position and handling were assessed by videotaping infants during the study periods. Results indicated that infants had more stress responses while wearing eye goggles and earmuffs since maximum HR was found to be significantly higher and high-frequency power of HRV significantly lower during the intervention as compared with the control period. Therefore, this intervention is not recommended for the clinical practice.
AitaM.GouletC. (2003). Assessment of neonatal nurses’ behaviors that prevent overstimulation in preterm infants. Intensive and Critical Care Nursing, 19, 109-118.
2.
AltuncuE.AkmanI.KulekciS.AkdasF.BilgenH.OzekE. (2009). Noise levels in neonatal intensive care unit and use of sound absorbing panel in the isolette. International Journal of Pediatric Otorhinolaryngology, 73, 951-953.
3.
American Academy of Pediatrics. (1997). Noise: A hazard for the fetus and newborn. Pediatrics, 100, 724-727.
4.
American Academy of Pediatrics, & American College of Obstetricians and Gynecologists. (2007). Guidelines for perinatal care (6th ed.). Elk Grove Village, IL: American Academy of Pediatrics.
5.
AnandK. S. (1993). Relationships between stress responses and clinical outcome in newborns, infants, and children. Critical Care Medicine, 21, S358-S359.
6.
BlackburnS.PattesonD. (1991). Effects of cycled light on activity state and cardiorespiratory function in preterm infants. Journal of Perinatal & Neonatal Nursing, 4(4), 47-54.
7.
CatelinC.TordjmanS.MorinV.OgerE.SizunJ. (2005). Clinical, physiologic, and biologic impact of environmental and behavioral interventions in neonates during a routine nursing procedure. Journal of Pain, 6, 791-797.
8.
CeruttiS.BianchiA. M.MainardiL. T. (1995). Spectral analysis of the heart rate variability signal. In MalikM.CammA. J. (Eds.), Heart rate variability (pp. 63-74). New York, NY: Futura.
9.
ChangY.-J.AndersonG. G.DowlingD.LinC.-H. (2002). Decreased activity and oxygen desaturation in prone ventilated preterm infants during the first postnatal week. Heart & Lung, 31, 34-42.
10.
ChangY.-J.PanY.-J.LinY.-J.ChangY.-Z.LinC.-H. (2006). A noise-sensor light alarm reduces noise in the newborn intensive care unit. American Journal of Perinatology, 23, 265-271.
11.
ColtonT. (1974). Statistics in medicine. Boston, MA: Little, Brown.
12.
Committee to Establish Recommended Standards for Newborn ICU Design. (2012). RecStandards for Newborn ICU Design (Eight Consensus Conference on Newborn ICU Design). Retrieved from http://www.nd.edu/~nicudes/stan%2027.html
13.
Conde-AgudeloA.BelizánJ. M.Diaz-RosselloJ. (2011). Kangaroo mother care to reduce mortality and morbidity in low birthweight infants. Cochrane Database of Systematic Reviews, (3), CD002771. doi:10.1002/14651858.CD002771.pub2
14.
DarcyA. E.HancockL. E.WareE. J. (2008). A descriptive study of noise in the neonatal intensive care unit. Advances in Neonatal Care, 8, 165-175.
15.
FeiL.StattersD. J.HnatkovaK.PolonieckiJ.MalikM.CammA. J. (1994). Change of autonomic influence on the heart immediately before the onset of spontaneous idiopathic ventricular tachycardia. Journal of the American College of Cardiology, 24, 1515-1522.
16.
GravenS. N. (2000). Sound and the developing infant in the NICU: Conclusions and recommendations for care. Journal of Perinatology, 20(8s), S88-S93.
17.
GravenS. N. (2011). Early visual development: Implications for neonatal intensive care unit and care. Clinics in Perinatology, 38, 671-683.
18.
HillsM.ArmitageP. (1979). The two-period cross-over clinical trial. British Journal of Clinical Pharmacology, 8, 7-20.
19.
JohnsonA. N. (2001). Neonatal response to control of noise inside the incubator. Pediatric Nursing, 27, 600-605.
20.
JohnstonC. C.FilionF.SniderL.MajnemerA.LimperopoulosC.WalkerC.-D.BoyerK. (2002). Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks’ postconceptional age. Pediatrics, 110, 523-528.
21.
JohnstonC. C.StevensB.PinelliJ.GibbinsS.FilionF.JackA.VeilleuxA. (2003). Kangaroo care is effective in diminishing pain response in preterm neonates. Archives of Pediatrics & Adolescent Medicine, 157, 1084-1088.
22.
KentW. D. T.TanA. K. W.ClarkeM. C.BardellT. (2002). Excessive noise levels in the neonatal ICU: Potential effects on auditory system development. Journal of Otolaryngology, 31, 355-360.
23.
KruegerC.WallS.ParkerL.NealisR. (2005). Elevated sound levels within a busy NICU. Neonatal Network, 24(6), 33-37.
24.
LaiT. T.BearerC. F. (2008). Iatrogenic environmental hazards in the neonatal intensive care unit. Clinics in Perinatology, 35, 163-181.
25.
LaskyR. E.WilliamsA. L. (2009). Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit. Pediatrics, 123, 540-546.
26.
LebelV.AitaM. (2011). Qu’en est-il de l’éclairage à l’unité néonatale? [What about the NICU lighting?] Recherche en soins infirmiers, 106, 32-39.
27.
LeeJ.BangK.-S. (2011). The effects of kangaroo care on maternal self-esteem and premature infants’ physiological stability. Korean Journal of Women Health Nursing, 17, 454-462.
28.
LeeY.-H.MalakootiN.LotasM. (2005). A comparison of the light-reduction capacity of commonly used incubators covers. Neonatal Network, 24(2), 37-44.
29.
LickliterR. (2011). The integrated development of sensory organization. Clinics in Perinatology, 38, 591-603.
30.
LongJ. C.PhilipA. G. S.LuceyJ. F. (1980). Excessive handling as a cause of hypoxemia. Pediatrics, 65, 203-207.
31.
MonterossoL.KristjansonL.ColeJ. (2002). Neuromotor development and the physiologic effects of positioning in very low birth weight infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31, 138-146.
32.
NyqvistK. H., & an Expert group of the International Network on Kangaroo Mother Care (2010). State of the art and recommendations. Kangaroo mother care: Application in a high-tech environment. Acta Paediatrica, 99, 812-819.
33.
OberlanderT.SaulJ. P. (2002). Methodological considerations for the use of heart rate variability as a measure of pain reactivity in vulnerable infants. Clinics in Perinatology, 29, 427-443.
34.
OzawaM.SasakiM.KandaK. (2010). Effect of procedure light on the physiological responses of preterm infants. Japan Journal of Nursing Science, 2010(7), 76-83.
35.
PengN.-H.BachmanJ.JenkinsR.ChenC.-H.ChangY.-C.ChangY.-S.WangT.-M. (2009). Relationships between environmental stressors and stress biobehavioral responses of preterm infants in NICU. Journal of Perinatal & Neonatal Nursing, 23, 363-371.
36.
PerlmanJ. M. (2001). Neurobehavioral deficits in premature graduates of intensive care: Potential medical and neonatal environmental risk factors. Pediatrics, 108, 1339-1348.
37.
PorgesS. W. (1992). Vagal tone: A physiologic marker of stress vulnerability. Pediatrics, 90, 498-504.
38.
PresslerJ. L.Turnage-CarrierC. S.KennerC. (2004). Developmental care: An overview. In KennerC.McGrathJ. M. (Eds.), Developmental care of newborns & infants. A guide for health professionals (pp. 1-34). St. Louis, MO: Mosby.
39.
RizzoP.RaeM.WhiteR. (2010). Lighting for today’s neonatal intensive care unit. Newborn and Infant Nursing Reviews, 10, 107-113.
40.
RosenstockE. G.CassutoY.ZmoraE. (1999). Heart rate variability in the neonate and infant: Analytical methods, physiological and clinical observations. Acta Paediatrica, 88, 477-482.
41.
SennS. (2002). Cross-over trials in clinical research (2nd ed.). Toronto, Ontario, Canada: John Wiley.
42.
ShiroiwaY.KamiyaY.UchiboriS.InukaiK.KitoH.ShibataT.OgawaJ. (1986). Activity, cardiac and respiratory responses of blindfold preterm infants in a neonatal intensive care unit. Early Human Development, 14, 259-265.
43.
SymingtonA.PinelliJ. (2006). Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database of Systematic Reviews, (2), CD001814. doi:10.1002/14651858.CD001814.pub2
44.
SzczepanskiM.KamianowskaM. (2008). The illumination intensity in the neonatal intensive care unit. Archives of Perinatal Medicine, 14, 47-50.
45.
ThomasK. A.UranA. (2007). How the NICU environment sounds to a preterm infant: Update. MCN: American Journal of Maternal/Child Nursing, 32, 250-253.
46.
VerklanM. T.PadhyeN. S. (2004). Spectral analysis of heart rate variability: An emerging tool for assessing stability during transition to extrauterine life. Journal of Obstetric, Gynecology, & Neonatal Nursing, 33, 256-265.
47.
WangY.-W.ChangY.-J. (2004). A preliminary study of bottom care effects on premature infants’ heart rate and oxygen saturation. Journal of Nursing Research, 12, 161-168.
48.
WechslerS. B.WernovskyG. (2008). Cardiac disorders. In ClohertyJ. P.EichenwaldE. C.StarkA. R. (Eds.), Manual of neonatal care (6th ed., pp. 388-435). New York, NY: Lippincott Williams & Wilkins.
49.
WhiteR. (2011). Designing environments for developmental care. Clinics in Perinatology, 38, 745-749.
50.
WilliamsA. L.SandersonM.LaiD.SelwynB. J.LaskyR. E. (2009). Intensive care noise and mean arterial blood pressure in extremely low-birth weight neonates. American Journal of Perinatology, 26, 323-329.
51.
ZahrL. K.BalianS. (1995). Responses of premature infants to routine nursing interventions and noise in the NICU. Nursing Research, 44, 179-185.
52.
ZahrL. K.de TraversayJ. (1995). Premature infant responses to noise reduction by earmuffs: Effects on behavioral and physiologic measures. Journal of Perinatology, 15, 448-455.
