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DOI
https://doi.org/10.63853/DCSB4787
Description
Purpose: Neonates and infants in a pediatric cardiac intensive care unit (CICU) are particularly susceptible to hemodynamic consequences of environmental exposure, agitation, and increased systemic vascular resistance associated with bathing. Clinical observations have generated significant debate regarding the physiologic changes that may occur related to patient bathing, leading to modified care practices surrounding routine bathing in the CICU. Due to the paucity of evidence surrounding physiologic changes associated with bathing in the CICU, we aim to describe the vital sign and hemodynamic profile of this high risk neonatal and infant population undergoing routine bathing in a pediatric CICU.
Methods: A prospective time series descriptive analysis of infants < 6 months of age admitted to the CICU at a quaternary care children’s hospital was performed by capturing vital signs from baseline (pre-bath) to time points during bath and after termination of bathing utilizing the T3 platform (Etiometry, Inc., Boston, MA). Demographics, bath event data, interventions in place at time of bath, and care escalations during bath were captured. Descriptive statistics were used to describe baseline patient and bath event level characteristics. Vital sign averages during pre/intra/post bath periods are reported and are compared with matched vital signs during bath and during the 60 min after bath ends to determine magnitude and direction of variance. Paired t tests were utilized to ensure that each patient serves as his or her own control. We compared VS changes between those needing interventions vs none.
Results: Twenty-two patients underwent 164 bath events over 4 weeks. Median age at each bath was 53 [11-155] days and median duration was 12 min [IQR 9-17 min]. Majority of baths occurred post-operatively (67%, n=110), in the evening (4PM - 11PM, 70%, n=115), and via non-immersion water/soap technique (58% n=96). Only 35% (n=57) of baths were in mechanically ventilated patients and 24% (n=39) were in single ventricle patients. No cardiac arrests were observed although bedside care escalations occurred in 38% (n=66) of events. Significant increases in HR (8.17 ± 1.81), mABP (4.91 mmHg ± 1.46 mmHg; p< 0.001 for all values) and lower POx (-1.72% ± 0.79%) and cerebral and renal NIRS values (-3.12% ± 1.12% and -4.14% ± 1.23%, respectively; P< 0.001 for all values) were observed. Lastly, renal oxygen extraction ratio (rO2ER) widened during bathing events (2.18%, P< 0.001).
Publication Date
11-24-2025
Disciplines
Pediatric Nursing
Recommended Citation
Torzone, Andrea, "Hemodynamic Effects of Bathing in the Pediatric Cardiac Intensive Care Unit" (2025). 2025. 25.
https://scholarlycollection.childrens.com/nursing-anf2025/25
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
