1 in 7 babies require neonatal care. During their time in hospital their vital signs (such as heart rate, breathing rate and oxygen saturation) are continuously monitored as part of standard care. Many factors lead to changes in vital signs, for example, medical procedures such as blood tests can result in brief increases in heart rate. Medication can also alter vital signs, either as an intended effect or as a side effect. However, different infants will respond in different ways to both procedures and medication. Predicting how an individual infant may respond could lead to better individualised care for infants. For example, using an infant's baseline vital signs to predict whether they will experience cardiorespiratory side effects from a particular drug could mean that doctors could choose an alternative safer treatment plan. To develop these predictive models, it is essential to first better understand how infants' vital signs are affected by different procedures and drugs, and how these effects are impacted by other factors such as infection, other pathologies, interaction between drugs and age. Despite their routine use in hospital neonatal units, detailed electronic records of vital signs are often not recorded. Often, only major events or average values are stated on clinical records. Subtle changes in vital signs are therefore missed, and more complex analysis that may reveal important predictive features within the data is not possible. In this study the investigators will electronically record infant vital signs across longer time periods and during a variety of clinically-necessary procedures and administration of drugs, to explore how these impact vital signs and are altered by factors such as age and pathology. These will be compared with control procedures, such as a nappy change, or when the infant is resting in their cot or receiving skin-to-skin care.
Study Type
OBSERVATIONAL
Enrollment
200
John Radcliffe Hospital
Oxford, United Kingdom
RECRUITINGChange in heart rate following drug administration
To characterise the change in heart rate in infants following drug administration in a wide range of commonly used drugs in neonatal care. Drugs will only be administered as part of clinical care, no drugs are administered for research purposes
Time frame: 1 day after drug administration, compared with baseline of 1 day before drug administration.
Change in oxygen saturation following drug administration
To characterise the change in oxygen saturation in infants following drug administration in a wide range of commonly used drugs in neonatal care. Drugs will only be administered as part of clinical care, no drugs are administered for research purposes
Time frame: 1 day after drug administration, compared with baseline of 1 day before drug administration.
Change in respiratory rate following drug administration
To characterise the change in heart rate in infants following drug administration in a wide range of commonly used drugs in neonatal care. Drugs will only be administered as part of clinical care, no drugs are administered for research purposes
Time frame: 1 day after drug administration, compared with baseline of 1 day before drug administration.
Change in heart rate following procedures
To characterise the change in heart rate in infants in relation to procedures, including (but not limited to) intubation and extubation, LISA (less invasive surfactant administration), blood transfusion and acute medically-required painful procedures.
Time frame: 1 day after procedure, compared with baseline of 1 day before procedure.
Change in oxygen saturation following procedures
To characterise the change in oxygen saturation in infants in relation to procedures, including (but not limited to) intubation and extubation, LISA (less invasive surfactant administration), blood transfusion and acute medically-required painful procedures.
Time frame: 1 day after procedure, compared with baseline of 1 day before procedure.
Change in respiratory rate following procedures
To characterise the change in respiratory rate in infants in relation to procedures, including (but not limited to) intubation and extubation, LISA (less invasive surfactant administration), blood transfusion and acute medically-required painful procedures.
Time frame: 1 day after procedure, compared with baseline of 1 day before procedure.
Models of drug response
Prediction of drug regimen requirements in individual infants from respiratory rate.
Time frame: 1 day after drug administration, compared with baseline of 1 day before drug administration.
Models of procedure response
Prediction of procedure outcome in individual infants (e.g. extubation success) from respiratory rate
Time frame: 1 day after procedure, compared with baseline of 1 day before procedure.
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