Automated tactile stimulation in response to cardiorespiratory events in preterm infants: a feasibility study.

Objective: Assess the feasibility and safety of a purpose-built automated tactile stimulation device (ATSD) responding to cardiorespiratory events in preterm infants.

Design: Randomised cross-over study.

Setting: Level-III neonatal intensive care unit in the Netherlands.

Patients: Infants born between 24 and 30 weeks gestational age, receiving non-invasive respiratory support and experiencing apnoea, bradycardia and/or hypoxia for>10 s.

Interventions: Infants underwent two study periods of 24 hours. In the control period, the ATSD was attached but inactive. In the intervention period, ATSD was activated and used in addition to standard care, providing direct vibratory stimulation in response to clinical alarms.

Main outcome measure: Feasibility of using ATSD, expressed by the number of infants completing the study, the ability to provide stimulation on the skin and the perceived feasibility by the nurses.

Results: 16 infants were included, of which 14 (88%) completed both study periods. Two infants were withdrawn from the study prematurely: one infant required intubation for cyanotic spells and the other developed local non-blanching erythema consistent with a mild pressure ulcer, on which the device was removed. During the intervention period, ATSD correctly detected 84% of the cardiorespiratory events, with automatic stimulation following 100% of the events. Nurses found the ATSD easy to use and rated the clinical utility neutral to positive.

Conclusion: Applying automated tactile stimulation in preterm infants using a purpose-built device is feasible, was well tolerated by infants and nurses considered our device useful and easy to use.

Trial registration details: Dutch national trial register, NL9606.