Mekanik ventilasyon modlarının prematüre bebeklerin tükürük kortizol düzeylerine etkisi

Year 2023, Volume: 48 Issue: 4, 1339 - 1346, 29.12.2023

Mehmet Satar , Selin Kaplan , Abdullah Tuli , Ümmühan Fulden Aydın , Hacer Yapıcıoğlu , Nejat Narlı

https://doi.org/10.17826/cumj.1357170

Abstract

Amaç: Bu çalışmada prematüre bebeklerin tükürük kortizol düzeyini ölçerek mekanik ventilasyon modları ile stres düzeyleri arasındaki ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntem: Çalışma grubunu solunum desteği alan 65 prematüre bebek, kontrol grubunu ise 43 prematüre bebek oluşturdu. Ağrının değerlendirilmesinde Yenidoğan Bebek Ağrı Ölçeği (NIPS) kullanıldı. Stres düzeyini belirlemek amacıyla doğum sonrası 4. gün sabah ve akşam alınan tükürük örneklerinde tükürük kortizol düzeylerine bakıldı.
Bulgular: Çalışma grubundaki bebeklerin sabah kortizol değerleri 8,33±5,7 ng/ml, akşam kortizol değerleri 8,05±5,6 ng/ml, kontrol grubundaki bebeklerin sabah kortizol değerleri 1,50±0,7 ng/ml, akşam kortizol değerleri 1,48±0,7 ng/ml ölçüldü. Çalışma grubundaki bebeklerin sabah ve akşam tükürük kortizol düzeyleri kontrol grubundaki bebeklere göre anlamlı düzeyde yüksek bulundu. Çalışma grubundaki bebeklerden invaziv mekanik ventilasyon uygulanan bebeklerin sabah kortizol değerleri 12,46±5,3 ng/ml, akşam kortizol değerleri 12,0±5,2 ng/ml, non-invaziv mekanik ventilasyon uygulanan bebeklerin sabah kortizol değerleri 4,57±2,7 ng/ml, akşam kortizol değerleri 4,41±2,7 ng/ml ölçüldü. İnvaziv mekanik ventilasyon uygulanan bebeklerin hem sabah hem de akşam tükürük kortizol düzeyleri, non-invaziv mekanik ventilasyon uygulanan bebeklerin kortizol düzeylerinden yüksekti.
Sonuç: İnvaziv yöntemlerde artan tükürük kortizol düzeyleri, entübasyonun yenidoğanlarda ağrı ve strese neden olduğunu göstermektedir.

Keywords

Yenidoğan, tükürük kortizol, invaziv, non-invaziv mekanik ventilasyon

Project Number

Cukurova University Scientific Project Department funded this study, Project number TTU-2020-13052.

Effect of mechanical ventilation modes on salivary cortisol levels in preterm infants

Abstract

Purpose: The aim of this study was to examine the relationship between mechanical ventilation modes and stress levels by measuring salivary cortisol levels in preterm infants.
Materials and Methods: The study group comprised 65 preterm infants on respiratory support and 43 control preterm infants. The Neonatal Infant Pain Scale (NIPS) was used to evaluate pain. To determine the stress level, salivary cortisol levels were studied in saliva samples taken in the morning and evening on the 4th postnatal day.
Results: In the study group, morning and evening cortisol levels of the infants were measured 8.33±5.7 ng/ml and 8.05±5.6 ng/ml, respectively. In the control group, morning and evening cortisol values of the infants were measured 1.50±0.7 ng/ml and 1.48±0.7 ng/ml, respectively. The morning and evening salivary cortisol levels of the infants in the study group were significantly higher than those of the infants in the control group. In the invasive mechanical ventilation group infants, morning and evening cortisol levels of the infants were measured 12.46±5,3 ng/ml and 12.0±5,2 ng/ml, respectively. In the non-invasive mechanical ventilation group, morning and evening cortisol values were measured 4.57±2.7 ng/ml and 4.41±2.7 ng/ml, respectively. Both morning and evening salivary cortisol levels of infants on invasive mechanical ventilation were higher than those of infants on non-invasive mechanical ventilation.
Conclusion: Increased salivary cortisol levels in invasive modes indicate that intubation causes pain and stress in newborns.

Keywords

Neonatal, Salivary Cortisol, Invasive, Non-invasive Mechanical Ventilation

Supporting Institution

Çukurova Üniversitesi

Project Number

Cukurova University Scientific Project Department funded this study, Project number TTU-2020-13052.

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