A Randomized Controlled Trial of the Use of Oral Glucose with or without Gentle Facilitated Tucking of Infants during Neonatal Echocardiography.

OBJECTIVE: To compare the effect of oral glucose given with or without facilitated tucking (FT), versus placebo (water) to facilitate image acquisition during a targeted neonatal echocardiography (TNE).

DESIGN: Factorial, double blind, randomized controlled trial.

SETTING: Tertiary neonatal intensive care unit (NICU).

PATIENTS: Infants born between 26 and 42 weeks of gestation (GA).

INTERVENTIONS: One of four treatment groups: oral water (placebo), oral glucose (25%), facilitated tucking with oral water or facilitated tucking with oral glucose, during a single, structured TNE. All infants received a soother.

MAIN OUTCOME MEASURE: Change in Behavioral Indicators of Infant Pain (BIIP) scores.

RESULTS: 104 preterm infants were randomized (mean ± SD GA: 33.4 ± 3.5 weeks). BIIP scores remained low during the echocardiography scan (median, [IQ range]: 0, [0 to 1]). There were no differences in the level of agitation of infants amongst the treatment groups, with estimated reductions in mean BIIP relative to control of 0.27 (95%CI -0.40 to 0.94) with use of oral glucose and .04 (-0.63 to 0.70) with facilitated tucking. There were also no differences between treatment groups in the quality and duration of the echocardiography scans.

CONCLUSIONS: In stable infants in the NICU, a TNE can be performed with minimal disruption in a majority of cases, simply by providing a soother. The use of 25% glucose water in this context did not provide further benefit in reducing agitation and improving image acquisition.

CLINICAL TRIAL REGISTRATION: Clinical Trials.gov: NCT01253889.