RESUMEN
AIM: The aim of this study is to investigate the effectiveness of the bladder stimulation technique (BST) to collect urine samples from newborns and its effects on physiological parameters and comfort of the newborn. DESIGN: This was a randomized controlled trial conducted in a NICU. A total of 64 newborns were divided into 2 groups: 32 newborns in the experimental group and 32 newborns in the control group. METHODS: Newborns in the experimental group (EG) were subjected to the BST, and in the control group (CG), urine collection was via sterile urine bags, which is routine practice. Procedural success was defined as the collection of urine samples within 3 min of beginning the stimulation technique in the experimental group and of placing the sterile urine bag in the control group. RESULTS: The success rate of the procedure in 3 min was 62.5% in the EG and 28% in the CG (P = 0.006, absolute difference: 35%, 95% confidence interval 27% to 42%, NNT: 3). According to the comparison of the overall mean COMFORTneo scale and pain and distress subscale scores at the 1- and 3-min marks, there was a significant difference between the EG and CG (p < 0.05). The mean scores in the EG were higher than those in the CG. The mean oxygen-saturation was significantly lower in the EG than in the CG (p < 0.05), and the increase in heart rate was significantly higher in the EG (p = 0.018). CONCLUSIONS: BST is a more successful method within 3 min for collecting urine samples from newborns compared to sterile urine bags. However, the newborns' comfort levels minimally decreased at 3 min, and they had moderate pain and distress, while the BST was being implemented. This increase in physiologic parameters was statistically significant but not clinically significant.
RESUMEN
Premature infants' gastric residual volume may be affected by position. This systematic review was conducted to examine the effect of lying position on the gastric residual volume of preterm newborns fed by gastric tube. Electronic databases (PubMed, MEDLINE, MEDLINE Complete, Academic Search Ultimate, CINAHL Complete, Cochrane, and Scopus) were searched for randomized controlled experimental or quasiexperimental studies in English published between 2011 and 2022 investigating the effect of one or more lying positions on gastric residual volume in premature newborns. The PICOS strategy was used in preparing and reporting the systematic review. A total of 304 articles were retrieved, and the full texts of 12 articles were evaluated for suitability. After eliminating the excluded articles, 10 articles were included in the analysis. The quality of evidence varied, with four studies judged to have poor quality whereas the remaining six were considered to range from moderate to good in quality. Based on the results obtained from the studies, it was determined that gastric residual volume was the least in the right lateral and prone positions and more in the left lateral and supine positions compared with the other two positions, with no difference between the two latter positions. The methodological differences, such as the evaluation of different positions, the timing of positioning and the duration of maintaining in the same position, and the measurement times of gastric residual volume made it difficult to reach a definitive proof. We concluded that high-evidence studies evaluating all positions are needed.