631 - Tiny tentacles, Big Impact: Reducing Stress in the NICU

Publication Number: 4617.631

Camila Gonzalez, New York Presbyterian Brooklyn Methodist Hospital, New York, NY, United States; Oksana Nulman, Weill Cornell Medicine, Brooklyn, NY, United States; Chun Wah (Angela) Hsu, Weill Cornell Medicine, Elmhurst, NY, United States; Jessica Restivo, NewYork-Presbyterian Brooklyn Methodist Hospital, Staten Island, NY, United States; Danthanh Hoang, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States

Background: Premature infants in the NICU are frequently exposed to stressors like excessive light, noise and separation from their caregivers, which can disrupt physiologic stability and neurodevelopment. Tactile and sensory based interventions have been associated with improvement in their neurobehavioral regulation. The knit octopus has been proposed as a comfort object to reduce stress in preterm infants and support their self regulation.

Objective: Evaluate the effect of a comfort object such as the knit octopus on the behavioral and physiological status of premature infants born between 24 and 32 weeks.

Design/Methods: The study included 24 preterm infants that were randomized into two groups to receive either standard care or placement of a knit octopus near them. Each infant had a total of three 15-minute observation sessions, which occurred between routine care to not interfere with patient care. Vital signs (heart rate, respiratory rate and oxygen saturation) were recorded at 0, 5, 10 and 15 minutes. Stress and self-regulatory behaviors were quantified by frequency and duration. Infants under continuous sedation or with limb anomalies affecting development were excluded.

Results: A total of 24 participants (12 control, 12 octopus) completed the study. Both groups were similar in sex, and race. Compared to controls, infants in the octopus group showed significantly fewer stress behaviors: salutes (1.68 fewer, 95% CI), finger splays (1.13 fewer, 95% CI), leg extensions (1.14 fewer, 90% CI), and air sitting (1.03 fewer, 90% CI). Vital sign analysis showed that the octopus group demonstrated reduced variability, reflecting greater physiologic stability. Average heart rate was 12.3 bpm higher in the octopus group (99% CI), while respiratory rate was 10.5 bpm lower. HR remained stable (160-170 bpm), during observation period, while the control group showed a marked dip at 5 minutes (140 bpm) before returning to baseline. RR in the octopus group remained stable, while in the control group there was a peak at 10 minutes (80 rpm), followed by a drop. Oxygen saturation in the octopus group remained consistently high (95-97%), while the control group had a dip to 87% at 10 minutes.

Conclusion(s): The octopus intervention was associated with fewer stress related behaviors and reduced variability in vital signs which could suggest an enhanced physiologic stability and a calming neuroprotective effect. These findings support the idea that the use of tactile, sensory based interventions can promote self-regulation and increase well-being