Recording of Amplitude-Integrated Electroencephalography, Oxygen Saturation, Pulse Rate, and Cerebral Blood Flow during Massage of Premature Infants

Abstract

Objective Stimulation of the nervous system plays an important role in brain function and psychomotor development of children. Massage can benefit premature infants, but has limitations.

Study Design The authors conducted a study to verify the direct effects of massage on amplitude-integrated electroencephalography (aEEG), oxygen saturation (SaO₂), and pulse analyzed by color cerebral function monitor (CCFM) and cerebral blood flow assessed by the Doppler technique.

Results The amplitude of the aEEG trend during massage significantly increased. Massage also impacted the dominant frequency δ waves. Frequency significantly increased during the massage and return to baseline after treatment. SaO₂ significantly decreased during massage. In four premature infants, massage was discontinued due to desaturation below 85%. Pulse frequency during the massage decreased but remained within physiological limits of greater than 100 beats per minute in all infants. Doppler flow values in the anterior cerebral artery measured before and after massage did not show statistically significant changes. Resistance index after massage decreased, which might provide greater perfusion of the brain, but this difference was not statistically significant.

Conclusion Use of the CCFM device allows for monitoring of three basic physiologic functions, namely aEEG, SaO₂, and pulse, and increases the safety of massage in preterm infants.

Keywords

premature infants - massage - color cerebral function monitor

Publication History

Received: 29 December 2011

Accepted: 04 January 2012

Publication Date:
11 April 2012 (online)

• References

• 1 Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant Behav Dev 2010; 33: 115-124
• 2 Field T, Diego M, Hernandez-Reif M. et al. Insulin and insulin-like growth factor-1 increased in preterm neonates following massage therapy. J Dev Behav Pediatr 2008; 29: 463-466
• 3 Caruana E. Infant (Preterm and/or Low Birth-Weight) Massage. Evidence Summaries. Adelaide, Australia: Joanna Briggs Institute; 2007
• 4 Rennie JM. Neonatal Cerebral Ultrasound. Cambridge, UK: Cambridge University Press; 1997
• 5 Eken P, Toet MC, Groenendaal F, de Vries LS. Predictive value of early neuroimaging, pulsed Doppler and neurophysiology in full term infants with hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 1995; 73: F75-F80
• 6 Dean LM, Taylor GA. The intracranial venous system in infants: normal and abnormal findings on duplex and color Doppler sonography. AJR Am J Roentgenol 1995; 164: 151-156
• 7 Field T, Diego M, Hernandez-Reif M. Moderate pressure is essential for massage therapy effects. Int J Neurosci 2010; 120: 381-385
• 8 Blackburn S. Central nervous system vulnerabilities in preterm infants, part II. J Perinat Neonatal Nurs 2009; 23: 108-110
• 9 Kimber L, McNabb M, Mc Court C, Haines A, Brocklehurst P. Massage or music for pain relief in labour: a pilot randomised placebo controlled trial. Eur J Pain 2008; 12: 961-969
• 10 Chen LL, Su YC, Su CH, Lin HC, Kuo HW. Acupressure and meridian massage: combined effects on increasing body weight in premature infants. J Clin Nurs 2008; 17: 1174-1181
• 11 Jump VK, Fargo JD, Akers JF. Impact of massage therapy on health outcomes among orphaned infants in Ecuador: results of a randomized clinical trial. Fam Community Health 2006; 29: 314-319
• 12 Kraus A. [Promoting the development of premature infants by massage]. Kinderkrankenschwester 2005; 24: 29-31
• 13 Mendes EW, Procianoy RS. Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. J Perinatol 2008; 28: 815-820
• 14 Mathur AM, Morris LD, Teteh F, Inder TE, Zempel J. Utility of prolonged bedside amplitude-integrated encephalogram in encephalopathic infants. Am J Perinatol 2008; 25: 611-615
• 15 Leboyer F. Loving Hands; The Traditional Art of Baby Massage. New York: Newmarket Press; 1997
• 16 Rennie JM, Hogmann CF, Robertson CF. Neonatal Cerebral Investigation. Cambridge, UK: Cambridge University Press; 2008: 9-21
• 17 Volpe JJ. Neurology of the Newborn. 4th ed. Philadelphia: W.B. Saunders Company; 2001: 141-158
• 18 Guzzetta A, D'Acunto MG, Carotenuto M. et al. The effects of preterm infant massage on brain electrical activity. Dev Med Child Neurol 2011; 53 (Suppl. 04) 46-51