慢性肺疾病(chronic lung disease, CLD)早產兒在嘗試口腔餵食過程中，由於其吸吮-吞嚥-呼吸之協調能力較一般健康早產兒為差，使其餵食過程發生血氧飽和濃度(oxygen saturation, SpO2)下降、心搏過緩、或心跳速率(heart rate, HR)加速等情形，以致於增加早產兒耗氧、影響其腦部神經發展與出院時機。本研究目的為瞭解罹患慢性肺疾病早產兒在嘗試口腔餵食初期餵食前、中、後HR與SpO2之變化。
研究方法採描述性相關性研究設計、二手資料庫分析，探討45名矯正年齡35.5±1.2週之CLD早產兒嘗試口腔餵食初期一星期內，餵食前、中、後心跳速率與血氧飽和濃度之變化與關係。HR變化事件乃指HR上升或下降超過餵食前HR平均值加減2個標準差之事件，SpO2下降事件則指SpO2下降超過餵食前SpO2平均值減2個標準差之事件，而SpO2<90%之事件亦納入本研究之分析。
結果發現（1）餵食中之HR平均值、上升事件數、上升事件時間長度、上升事件變化最大值、與下降事件變化最大值均較餵食前多；（2）餵食中之SpO2平均值較低，SpO2變化事件數、時間長度、變化最大值均較餵食前多；（3）HR、SpO2變化關連事件多是先出現HR變化事件後才出現SpO2下降事件；（4）PMA越大者餵食中HR平均值越低、上升事件時間長度越短；（5）CLD越嚴重者其餵食中SpO2變化亦越嚴重。故本研究結果呈現CLD早產兒在口腔餵食過程之心肺調節現象與關係，更提供臨床照護者餵食CLD早產兒時，需評斷其餵食過程生理變化與自我調節之依據。

Preterm infants with chronic lung disease (CLD) have more difficulties in coordination of suck-swallow-breathe during the transition from tube to oral feeding. Desaturation, bradycardia, and heart rate (HR) acceleration are common response of preterm infants which may increase oxygen consumption and affect neurodevelopment and the decision of discharge. The purpose of this study was to explore changes of HR and oxygen saturation (SpO2) in preterm infants with CLD at the early stage of transition from tube to oral feeding.
A correlational study was conducted. The data was retrieved from a data bank of feeding studies in preterm infants. Forty-five CLD infants with postmenstrual age (PMA) of 35.5±1.2 weeks were studied. HR change event was defined as HR increased or decreased by 2 standard deviation (SD) of pre-feeding. SpO2 decreased was defined as the changed amount reached to 2SD of pre-feeding. Oxygen desaturation less than 90% was also analyzed.
Results of this study show that during feeding (1) the average HR, frequency, duration, and maximum change of HR increased events increased, (2) SpO2 decreased and the frequency, duration, and maximum change of SpO2 decreased events increased, (3) the majority of subjects experienced the time order of HR changed then SpO2 decreased, (4) PMA was significantly negative associated with the mean of HR and duration of HR increased events, and (5) the severity of CLD was positive associated with the maximum change of SpO2 decreased events. Results of this study provide information of cardiorespiratory interaction during feeding in preterm infants with CLD. These allow caregivers to recognize infants’ self-regulation process, capacity and related factors.

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