Neonatal Assessment Manual Score: Is There a Role of a Novel, Structured Touch-Based Evaluation in Neonatal Intensive Care Unit?

Frontiers in Pediatrics

article

Andrea Manzotti¹  Francesco Cerritelli¹  Marco Chiera¹  Erica Lombardi¹  Simona La Rocca¹  Pamela Biasi¹  Matteo Galli¹  Jorge Esteves⁴  Gianluca Lista² 

[1]RAISE Laboratory, Foundation COME Collaboration

[2]Division of Neonatology, “V. Buzzi” Children's Hospital

[3]Research Department, Istituto Osteopatia Milano

[4]Gulf National Centre, Foundation COME Collaboration

[5]Research Department, University College of Osteopathy, United Kingdom

关键词: neonatology;    manual assessment;    haptic perception;    body volume;    autonomic nervous system;    prematurity;    touch;    neonatal intensive care unit;   

DOI  :  10.3389/fped.2020.00432

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Despite the technological improvements in monitoring preterm infants in the neonatal intensive care unit, routine care in the neonatal ward is primarily based on manual procedures. Although manual clinical procedures play a critical role in neonatology, little attention has been paid to palpation as a clinical assessment tool. Palpation is a clinical evaluation tool that relies mostly on the senses of touch and proprioception. Based on recent studies investigating the role and clinical effectiveness of touch in full-term and preterm babies, this paper proposes an evaluative touch-based procedure—the Neonatal Assessment Manual Score (NAME) model—that could be useful in the neonatal ward and describes its rationale. The operator applies gentle light pressures to the infant's body. In essence, the touch stimulates low-threshold afferent fibers that could influence the interoceptive cerebral network and the autonomic nervous system, thus altering the blood flow and breathing rhythm. These events could change how bodily fluids distribute among body segments and hence the body volume. The volume modification could be felt manually through haptic perception owing to the high sensitivity of the fingers. On the basis of their clinical conditions and stage of development, infants will respond differently to the applied pressures. Evaluating the infant's response, the operator produces a score of “bad,” “marginal,” or “good” for communicating quickly and clearly the infant's conditions to other professionals. Because the NAME model is intended for every professional who is used to touch-based procedures, if future studies confirmed its validity and reliability in clinical practice, the NAME model could become a part of the neonatal ward routine care for better assessing and managing the infant's conditions, even during emergencies.

【 授权许可】

CC BY