Effects of semi-upright swings on vital signs in NICU infants

Background The aim of this study was to compare the impact of a semi-upright swing with a standard crib on vital signs in infants in the neonatal intensive care unit (NICU). Methods We performed a within-subjects’ comparison of vital signs of NICU infants corrected to ≥34 weeks of gestation and placed in the supine position versus the semi-upright position in a swing. The primary outcome was the mean oxygen saturation, and the secondary outcomes were the mean heart rate, the proportion of time with oxygen saturation (SpO 2 ) <90%, and respiratory rate. Results Of the 65 infants, 34 (57%) were male and 32 (50%) were black. The mean ± SD gestational age at birth was 32.4 ± 5.1 weeks. In all, 40% were on noninvasive respiratory support. There were no significant differences in oxygen saturation, heart rate, time with oxygen desaturation defined by SpO 2 < 90%, or respiratory rate between the supine and semi-upright positions. A higher risk of desaturations was observed in infants without respiratory support (RR, 1.24, 95% CI, 1.15–1.33) and low-birth-weight infants (RR, 1.55, 95% CI, 1.42–1.69). Conclusions The placement of infants in a semi-upright swing resulted in no discernible differences in averaged vital signs compared to the supine position in NICU infants. Impact We identified no significant differences in averaged oxygen saturation, heart rate, or respiratory rate among NICU infants placed in a semi-upright swing compared to the supine position. Desaturation events occurred at a higher frequency in low-birth-weight infants and those on room air when placed in the swing, although none required oxygen supplementation. The results from the current study support that it is probably safe to use semi-upright swings in the NICU environment, although additional studies are necessary for generalization to the unmonitored home environment.