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. 2017 Apr 20;12(4):e0175981.
doi: 10.1371/journal.pone.0175981. eCollection 2017.

Vibrotactile stimulation: A non-pharmacological intervention for opioid-exposed newborns

Ian Zuzarte  1 , Premananda Indic  1 , Bruce Barton  2 , David Paydarfar  1   3 , Francis Bednarek  4 , Elisabeth Bloch-Salisbury  4
Affiliations

Vibrotactile stimulation: A non-pharmacological intervention for opioid-exposed newborns

Ian Zuzarte et al. PLoS One. .

Abstract

Objective: To examine the therapeutic potential of stochastic vibrotactile stimulation (SVS) as a complementary non-pharmacological intervention for withdrawal in opioid-exposed newborns.

Study design: A prospective, within-subjects single-center study was conducted in 26 opioid-exposed newborns (>37 weeks; 16 male) hospitalized since birth and treated pharmacologically for Neonatal Abstinence Syndrome. A specially-constructed mattress delivered low-level SVS (30-60Hz, 10-12μm RMS), alternated in 30-min intervals between continuous vibration (ON) and no vibration (OFF) over a 6-8 hr session. Movement activity, heart rate, respiratory rate, axillary temperature and blood-oxygen saturation were calculated separately for ON and OFF.

Results: There was a 35% reduction in movement activity with SVS (p<0.001), with significantly fewer movement periods >30 sec duration for ON than OFF (p = 0.003). Incidents of tachypneic breaths and tachycardic heart beats were each significantly reduced with SVS, whereas incidents of eupneic breaths and eucardic heart beats each significantly increased with SVS (p<0.03). Infants maintained body temperature and arterial-blood oxygen level independent of stimulation condition.

Conclusions: SVS reduced hyperirritability and pathophysiological instabilities commonly observed in pharmacologically-managed opioid-exposed newborns. SVS may provide an effective complementary therapeutic intervention for improving autonomic function in newborns with Neonatal Abstinence Syndrome.

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Conflict of interest statement

Competing Interests: Dr. Salisbury and Dr. Paydarfar are co-inventors for the stochastic vibrotactile stimulation mattress for Neonatal Abstinence Syndrome (PCT/US2015/021999: Methods and systems for reducing irritability in infants). Mr. Zuzarte, Dr. Indic and Dr. Paydarfar are co-inventors for the automated movement analysis program (PCT/US2014/037115: Systems and methods for inhibiting apneic and hypoxic events) described in the Methods section. The authors have no other financial relationships relevant to this article to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Example of experimental protocol and recorded signals (Subject 24).
Signals are condensed. SVS = Stochastic Vibrotactile Stimulation; RIP = Respiratory Inductance Plethysmography; Abd = Abdomen; ECG = Electrocardiogram; SaO2 = Blood-oxygen saturation; QPleth = Quality of Plethysmography; Temp = Temperature. Note the increase in movement artifact in the physiological signals during OFF compared to ON.
Fig 2
Fig 2. Physiological response to SVS.
Upper panel: Improved cardio-respiratory stability and reduced movement with stimulation. Lower panel: Expanded view: 1) ECG: Arrows indicate heart rate calculated from cardiac R-waves; 2) RIP Abdomen: Respiratory inductance plethysmography; Arrows indicate respiratory rate determined from inspiratory peak; 3) QPleth: Gray line indicates distortion from movement activity.
Fig 3
Fig 3. Change in movement with SVS among subjects.
SVS reduced movement duration in 23 of the 26 subjects.
See this image and copyright information in PMC

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