Effect of Light and Noise on Physiological Parameters in a Sample of Preterm Neonates in the Neonatal Intensive Care of Cairo University Teaching Hospital

Document Type : Original Article

Authors

1 Pediatric Department, Faculty of Medicine, Cairo University, Egypt

2 Clinical and Chemical Pathology Department, National Research Centre, Cairo, Egypt

Abstract

Background: Some of the neonatal intensive care units (NICUs) partially lack the standard protocols for controlling noise and light. The healthy physical environment of NICUs is crucial for the continued normal development of preterm neonates. The present study aimed to assess the physiological changes (including heart rate, respiratory rate, blood pressure, temperature, and oxygen saturation) induced by noise and ordinary light often existing in NICUs in a sample of preterm neonates admitted to the private ward of NIUCU due to their low-birth weights.
Methods: The present study included 100 preterm neonates, 50 neonates were exposed to noise which is often induced in the open ward of NICU, and the other 50 newborns were exposed to cyclical light.
Results: During noise exposure, neonates in the private ward displayed a significant increase in heart rate, respiratory rate, as well as systolic and diastolic blood pressure. Moreover, they showed a marked decrease in oxygen saturation in the first and second days in the NICU. Furthermore, the neonates exposed to dim light demonstrated a significant decrease in heart rate, respiratory rate, systolic and diastolic blood pressure, as well as a significant increase in oxygen saturation, compared to those exposed to ordinary light on the first and second days. Nonetheless, body temperature did not show any significant change with noise or light exposure either on the first day or the second one.
Conclusion: As evidenced by the obtained results, exposure to excessive light and noise was associated with significant changes in preterm neonates' vital signs. Moreover, the findings highlighted the inadequacy of the current conditions in a sample of Egyptian NICUs for ideal neonatal care. In order to create a favorable environment to help better growth and prevent prematurity complications, it is recommended to devote more assiduous attention to the care conditions of neonates in NICUs in Egypt. 

Keywords


  1. Rodarte MDO, Fujinaga CI, Leite AM, Salla CM, Silva CGD, Scochi CGS, et al. Exposure and reactivity of the preterm infant to noise in the incubator. Codas. 2019; 31(5):e20170233.
  2. Rodríguez RG, Pattini AE. Neonatal intensive care unit lighting: update and recommendations. Arch Argent Pediatr. 2016; 114(4):361-7.
  3. Valizadeh S, Hosseini M, Jafarabadi MA, Mirnia K, Saeidi F, Jabraeeli M. Comparison of 2 methods of light reduction on preterm infants’ sleep pattern in NICU: a randomized controlled trial. Crescent J Med Biol Sci. 2017; 4(4):211-6.
  4. Galindo APG, Caicedo YC, Veléz-Pereira AM. Noise level in a neonatal intensive care unit in Santa Marta – Colombia. Colomb Med. 2017; 48(3):120-5.
  5. Aly HA, Ahmed AM. Effect of noise on neonatal vital data and behavior in NICU. Clin Med Diagnostics. 2016; 6:1-6.
  6. Lahav A. Questionable sound exposure outside of the womb: frequency analysis of environmental noise in the neonatal intensive care unit. Acta Paediatr. 2015; 104(1):e14-9.
  7. Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr. 2014; 164(1):52-60. e2.
  8. Santos J, Pearce SE, Stroustrup A. Impact of hospital-based environmental exposures on neurodevelop-mental outcomes of preterm infants. Curr Opin Pediatr. 2015; 27(2):254-60.
  9. Shimizu A, Matsuo H. Sound environments surrounding preterm infants within an occupied closed incubator. J Pediatr Nurs. 2016; 31(2): e149-54.

10. Vásquez-Ruiz S, Maya-Barrios JA, Torres-Narváez P, Vega-Martínez BR, Rojas-Granados A, Escobar C, et al. A light/dark cycle in the NICU accelerates body weight gain and shortens time to discharge in preterm infants. Early Hum Dev. 2014; 90(9):535-40.

11. Dhand NK, Khatkar MS. Statulator: an online statistical calculator. Sample size calculator for estimating a single proportion. Sydney, Australia: Statulator; 2014.

12. Venkataraman R, Kamaluddeen M, Amin H, Lodha A. Is less noise, light and parental/caregiver stress in the neonatal intensive care unit better for neonates? Indian Pediatr. 2018; 55(1):17-21.

13. Cardoso SM, Kozlowski Lde C, Lacerda AB, Marques JM, Ribas A. Newborn physiological responses to noise in the neonatal unit. Braz J Otorhinolaryngol. 2015; 81(6):583-8.

14. Romeu J, Cotrina L, Perapoch J, Linés M. Assessment of environmental noise and its effect on neonates in a Neonatal Intensive Care Unit. Appl Acoustics. 2016; 111:161-9.

15. Sinha KK, Kumar G. The effects of noise on neonates in the NICU. Indian Appl Res. 2016; 6(11):47-9.

16. Smith SW, Ortmann AJ, Clark WW. Noise in the neonatal intensive care unit: a new approach to examining acoustic events. Noise Health. 2018; 20(95):121-30.

17. Darcy AE, Hancock LE, Ware EJ. A descriptive study of noise in the neonatal intensive care unit: ambient levels and perceptions of contributing factors. Adv Neonatal Care. 2008; 8(5 Suppl):S16-26.

18. Knutson AJ. Acceptable noise levels for neonates in the neonatal intensive care unit. St. Louis, Missouri: Washington University School of Medicine; 2012. 

19. Williams AL, van Drongelen W, Lasky RE. Noise in contemporary neonatal intensive care. J Acoust Soc Am. 2007; 121(5 Pt1):2681-90.

20. Lasky RE, Williams AL. Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit. Pediatrics. 2009; 123(2):540-6.

21. Saunders AN. Incubator noise: a method to decrease decibels. Pediatr Nurs. 1995; 21(3):265-8.

22. Graven SN. Early neurosensory visual development of the fetus and newborn. Clin Perinatol. 2004; 31(2):199-216

23. Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clin Perinatol. 2004; 31(2):217-28.

24. Guyer C, Huber R, Fontijn J, Bucher HU, Nicolai H, Werner H, et al. Cycled light exposure reduces fussing and crying in very preterm infants. Pediatrics. 2012; 130(1):e145-51.

25. Lee KN, Seo BM, Moon DH, Jeon GW, Sin JB. Effect of lights-out at night time on body weight, physiological variables, and behavioral status in premature infants. Neonatal Med. 2016; 23(2):102-7.

26. Zores C, Dufour A, Pebayle T, Langlet C, Astruc D, Kuhn P. Very preterm infants can detect small variations in light levels in incubators. Acta Paediatr. 2015; 104(10):1005-11.

27. Lebel V, Aita M, Johnston C, Héon M, Dupuis F. Effects of cycled lighting versus continuous near darkness on physiological stability and motor activity level in preterm infants. Adv Neonatal Care. 2017; 17(4):282-91.

28. Reyhani T, Aemmi SZ, Sannadgol V, Boskabadi H. The effect of creating an artificial night on physiological changes in preterm infants. Int J Pediatr. 2014; 2(3-4):407-12.