The impact of two transfer techniques used during skin-to-skin care on thephysiologic and behavioral responses of preterm infants

Background: Conservation of energy assumes an important role in the care of infants requiring assisted ventilation, yet little research has been condu cted on this group of infants in terms of thermoregulation, oxygenation, he art rate, or sleep states during skin-to-skin care. Objectives: To compare the impact of two different transfer techniques used in skin-to-skin care (nurse transfer and parent transfer) on physiologic s tability and other descriptive measures of physiologic stability related to energy conservation in ventilated preterm infants during and after skin-to -skin care. Method: Fifteen ventilated preterm infants weighing a mean of 1,094 g were randomly assigned to receive either parent or nurse-to-parent transfer on t he first of 2 consecutive days and the alternate method the following day. Temperature was taken before and after skin-to-skin care. Oxygen saturation and heart rate were recorded minute by minute, and the Assessment of Behav ioral Systems Observation (ABSO) scale scores was used to measure physiolog ic organization, motor organization, self-regulation, and need for caregive r facilitation during transfer to and from the parent and during pre, post, and skin-to-skin periods. Results: Temperature remained stable. Oxygen saturation decreased and heart rate increased when the infant was transferred to and from the parent, but returned to baseline levels during and after skin-to-skin care regardless of the transfer method. Infants showed more physiologic and motor disorgani zation, less self-regulation, and more need for caregiver facilitation duri ng transfers to and from the parent than during the pre, post, and skin-to- skin care periods. Conclusions: Both transfer methods resulted in physiologic disorganization. However, during and after skin-to-skin care, infants exhibited no signs of energy depletion.