Physiological signs and behavioral states in preterm newborns subjected to two techniques of immersion bath: a crossover clinical trial

Abstract

The literature review indicates that preterm neonates submitted to immersion bath keeps the average body temperature post-bath higher than those submitted to the sponge bath. In Brazil, the Ministry of Health recommends the immersion bath to newborn preterm and low birth weight wrapped in tissue and immersed in the water bath. However, there is no evidence in the literature about the advantages of this technique on the stability of vital signs such as body temperature, heart rate, oxygen saturation and levels of salivary cortisol and sleep-awake state of preterm infants in relation to the bath conventional immersion.The objective of the study is to evaluate the physiological and behavioral signs of newborn preterm infants underwent conventional immersion bath (CIB) and the immersion bath with winding (WIB). Will be conducted randomized crossover clinical trial with a sample of 35 newborn preterm and a pilot study will be conducted to confirm the size of the sample. Neonates will be submitted to immersion bath conventional (control group) and the immersion bath with winding (experimental group). The axillary temperature , heart rate , oxygen saturation will be collected before the bath (baseline) , 10 and 30 minutes post- bath , except the salivary cortisol will be collected at baseline and 30 minutes after bathing. The behavioral state of the newborn before and after bath will be filmed and analyzed using the tool for assessment of sleep -awake state validated by Brandon and Holditch - Davis. Data will be recorded in a specific form and stored in Microsoft Excell spreadsheet.Will be performed measures of central tendency and dispersion; absolute and relative frequencies; nominal variables will be analyzed using the McNemar test for paired samples. The averages of continuous data will be analyzed by the t test for paired groups or Wilcoxon signaled. The project was approved by the Research Ethics Committee of the co-participant institution and the study will be recorded on the National Register of Clinical Trials (AU)