Critical Care Instructor Baylor College of Medicine Houston, Texas, United States
Abstract:
Objective: To assess the hemodynamic and oximetric changes of infants in cardiac intensive care unit while being held by their parent.
Design: Single-center, prospective study. Continuous data streaming of vital signs was collected for infants included in the study from January 2021 to March 2022. Demographic and clinical characteristics were also collected from the electronic medical record. The physiologic streaming data was analyzed using mixed-effects models to account for repeated measures and quantify the effect of parental holding while controlling for intubation, pre-operative vs post-operative status, and whether the holding was skin-to-skin or not.
Setting: Cardiac intensive care unit (CICU) of quaternary pediatric hospital.
Patients: Infants in the CICU between January 2021 and March 2022 were included in the study when precise holding start and stop times was documented in the electronic medical record by a member of the study team.
Interventions: Holding by the infants’ parents in assistance by the registered nurse or physical therapist.
Results: Ninety-five subjects with complete physiologic recording were included in the study. Sixty-four percent were male, 28% had single-ventricle physiology, 51% had post-op status, 34% were intubated during the holding, and 22% were held skin-to-skin. Heart rate decreased during the response time compared to its baseline value (p=0.01) and this decrease was more pronounced for the non-intubated and/or pre-operative patients. The blood pressure decreased, and pulse saturation increased but neither reach statistical significance. The NIRS-based venous saturation increased overall (p=0.02).
Conclusion: The holding of infants in the CICU by their parents is safe and the hemodynamic/oximetric profile during the holding is favorable compared to the baseline prior to holding.
