A randomized controlled trial of the use of oral glucose with or without gentle facilitated tucking of infants during neonatal echocardiography

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Abstract

OBJECTIVE: To compare the effect of oral glucose given with or without facilitated tucking (FT), versus placebo (water) to facilitate image acquisition during a targeted neonatal echocardiography (TNE).<br /><br />DESIGN: Factorial, double blind, randomized controlled trial.<br /><br />SETTING: Tertiary neonatal intensive care unit (NICU).<br /><br />PATIENTS: Infants born between 26 and 42 weeks of gestation (GA).<br /><br />INTERVENTIONS: One of four treatment groups: oral water (placebo), oral glucose (25%), facilitated tucking with oral water or facilitated tucking with oral glucose, during a single, structured TNE. All infants received a soother.<br /><br />MAIN OUTCOME MEASURE: Change in Behavioral Indicators of Infant Pain (BIIP) scores.<br /><br />RESULTS: 104 preterm infants were randomized (mean ± SD GA: 33.4 ± 3.5 weeks). BIIP scores remained low during the echocardiography scan (median, [IQ range]: 0, [0 to 1]). There were no differences in the level of agitation of infants amongst the treatment groups, with estimated reductions in mean BIIP relative to control of 0.27 (95%CI -0.40 to 0.94) with use of oral glucose and .04 (-0.63 to 0.70) with facilitated tucking. There were also no differences between treatment groups in the quality and duration of the echocardiography scans.<br /><br />CONCLUSIONS: In stable infants in the NICU, a TNE can be performed with minimal disruption in a majority of cases, simply by providing a soother. The use of 25% glucose water in this context did not provide further benefit in reducing agitation and improving image acquisition.<br /><br />CLINICAL TRIAL REGISTRATION: Clinical Trials.gov: NCT01253889.

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Lavoie, P. M., Stritzke, A., Ting, J., Jabr, M., Jain, A., Kwan, E., … Holsti Holsti, L. (2015). A randomized controlled trial of the use of oral glucose with or without gentle facilitated tucking of infants during neonatal echocardiography. PLoS ONE, 10(10). https://doi.org/10.1371/journal.pone.0141015

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