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Front. Pediatr. | doi: 10.3389/fped.2018.00045

Effect of tactile stimulation on termination and prevention of Apnea of Prematurity: a systematic review.

 Sophie J. Cramer1*,  Janneke Dekker2, Jenny Dankelman3, Steffen Pauws4,  Stuart B. Hooper5 and  Arjan Te Pas2
  • 1Instrumental Affairs, Leiden University Medical Center, Netherlands
  • 2Pediatrics, Leiden University Medical Center, Netherlands
  • 3Biomedical Engineering, Delft University of Technology, Netherlands
  • 4TiCC, Tilburg University, Netherlands
  • 5The Ritchie Center, Hudson Institute of Medical Research, Australia

Apnea of prematurity is one of the most common diagnoses in preterm infants. Severe and recurrent apneas are associated with cerebral injury and adverse neurodevelopmental outcome. Despite pharmacotherapy and respiratory support to prevent apneas, a proportion of infants continue to have apneas and often need tactile stimulation, mask and bag ventilation and/or extra oxygen. The duration of the apnea and the concomitant hypoxia and bradycardia depends on the response time of the nurse. We systematically reviewed the literature with the aim of providing an overview of what is known about the effect of manual and mechanical tactile stimulation on apnea of prematurity. Tactile stimulation, manual or mechanical, has been shown to shorten the duration of apnea, hypoxia and or bradycardia or even prevent an apnea. Automated stimulation, using closed-loop pulsating or vibrating systems, has been shown to be effective in terminating apneas, but data are scarce. Several studies used continuous mechanical stimulation, with pulsating, vibrating or oscillating stimuli, to prevent apneas, but the reported effect varied. More studies are needed to confirm whether automated stimulation using a closed loop is more effective than manual stimulation, how and where the automated stimulation should be performed and the potential side effects.

Keywords: preterm infants, tactile stimulation, apnea of prematurity, Apnoea, breathing

Received: 24 Nov 2017; Accepted: 15 Feb 2018.

Edited by:

Eugene Dempsey, University College Cork, Ireland

Reviewed by:

Gianluca Lista, Ospedale dei Bambini Vittore Buzzi, Italy
Hans Fuchs, Universitätsklinikum Freiburg, Germany  

Copyright: © 2018 Cramer, Dekker, Dankelman, Pauws, Hooper and Te Pas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ms. Sophie J. Cramer, Leiden University Medical Center, Instrumental Affairs, Albinusdreef 2, Leiden, 2333ZA, Zuid-Holland, Netherlands,