Physiologic changes of intubated premature infants during transfer procedures

Preterm infants demonstrate physiologic instability during handling. The purpose of this study was to describe physiologic changes that occur before transfer, during transfer, and after transfer of the premature intubated and mechanically ventilated very-low-birth-weight (VLBW) infant. A secondary analysis of previously acquired data from an experimental study of 14 ventilated VLBW infants during skin-to-skin (SSC) holding was conducted. Infants participating in the study were incubated, mechanically ventilated, and receiving full enteral feedings. Mean weight of infants was 757 grams, mean day of life that infants enrolled in the study was 35 days, and mean corrected gestational age was 35.5 weeks. A repeated-measures multivariate analysis of variance (RM MANOVA) and pos hoc t test to determine where significant differences occurred were employed. A significant within-subjects time effect was noted among the dependent variables (F = 8.06, p = .0001). Fraction of inspired oxygen (FiO2) was significantly higher during the preparation for (mean 47%) and transfer to the mother (mean 57%) compared to baseline (mean 37%) (p = .000). Although no significant temperature changes occurred during transfer, significant temperature instability was noted across time. Although the transfer was less than 3 minutes, infants lost a mean of 0.1°C (± 0.3°C). Temperature remained above baseline 90 minutes; infants were transferred back to the incubator after holding. The results of this study reveal that the preparation for transfer and the transfer are physiologically stressful to the premature intubated VLBW. Minimizing nursing-care activities, excessive handling, and transfer of these infants until they are more stable or mature may be more favorable for their growth and welfare.