manage neonatal stressors

because today decides tomorrow

A DAY IN THE LIFE OF THE NICU

Watch how the staff of Rush University Medical Center combats neonatal stress.

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A DAY IN THE LIFE OF THE NICU

Why Is Recognizing
NICU Stress
So Important?

Neonatal stress may have long-term effects on the physiological systems of fragile, preterm infants that may affect their development.1

This website is an educational resource, designed to help you manage neonatal stress and improve patient care.

Neonatal Stressors – Get the Facts. Know the Signs.

16 Procedures

Neonates experience as many as 16 stressful procedures a day.2

54-117db

NICU sound levels may range from 54-117 dB. The sound of a jet taking off is 125 dB.4

40-60%

A neonate’s skin is approximately
40% to 60% thinner
than an adult’s.3

14 days

Neonatal exposure to stressors is highest in the 14 days after birth.5

How Do These Stressors Affect Outcomes in Preterm Babies?

Respiratory
Stressors
Nutritional
Stressors
Infection
Stressors
Sensory
Stressors

Breathing is hard work for premature infants, and respiratory distress in the NICU can have a profound impact.

Nutritional stress can interfere with the growth and development of preterm infants.

Premature infants are at risk for infections that can prolong hospitalization and delay recovery.

Sensory stress in the NICU can have long-term implications for the premature infant.

See how respiratory stressors can affect the brain.

See how respiratory stressors can affect the eyes.

See how nutritional stressors can affect the brain.

See how nutritional stressors can affect the gut.

See how infection stressors can affect the skin.

See how sensory stressors can affect the brain.

See how sensory stressors can affect the skin.

Recognize the Signs of Stress in Preterm Babies

3 PHYSIOLOGICAL SIGNS OF STRESS*

Check physiological stress signals that may be reflected in respiration rate, heart rate, and oxygen saturation.6

*All signs of stress may not be described here. These signs may or may not indicate a stressful event.

Heart Rate

<100 or >160 beats/min or increase in baseline of ≥5 beats/min6

Respiration Rate

<40 or >60 breaths/min or increase in baseline of ≥7 breaths/min6

Oxygen Saturation

<90% or a decrease of at least 2.5%6

8 BEHAVIORAL SIGNS OF STRESS

Check these behaviors that are significantly correlated with NICU stress.6

grimace

sucking

salute

sitting on air

finger splay

holding on

yawning

hand-to-mouth

References

1. Newnham CA, Inder TE, Milgrom J. Measuring preterm cumulative stressors within the NICU: the Neonatal Infant Stressor Scale. Early Hum Dev. 2009;85(9):549-555.

2. De Lima J, Carmo JB. Practical pain management in the neonate. Best Pract & Res Clin Anaesth. 2010;24:291-307.

3. McNichol L, Lund C, Rosen T, Gray M. Medical adhesives and patient safety: state of the science. Orthop Nurs. 2013;32:267-281.

4. Brown G. NICU noise and the preterm infant. Neonatal Netw NN. 2009;28(3):165-173.

5. Smith GC, Gutovich J, Smyser C, et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011;70(4):541-549.

6.Peng N-H, Bachman J, Jenkins R, et al. Relationships between environmental stressors and stress biobehavioral responses of preterm infants in NICU. J Perinat Neonatal Nurs. 2009;23(4):363-371.

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