Acute physiological stress response during clinical use of a novel air mattress

Abstract Physiological stress can affect well-being and recovery in critically ill neonates and infants, and support surfaces may influence this response through mechanical loading. A segmented air mattress for neonates was developed to enhance envelopment and pressure redistribution, thereby reducing mechanical loading when compared to conventional foam mattresses. In a randomized crossover trial, 23 infants were monitored for 60 min while being exposed to a novel air mattress or a standard foam mattress as a comparator in a randomized order. Vital signs were recorded at 15-minute intervals using standard bedside monitoring. Furthermore, caregivers rated acute comfort and stress responses based on visual analogue scales at three defined time points for each support surface. Clinical handling procedures were found to elicit an immediate stress response in neonates, as reflected by acute increases in physiological parameters such as heart rate. Following repositioning, heart rate returned more rapidly toward baseline levels when infants were placed on the air mattress compared with the conventional foam mattress, indicating a faster recovery to pre-transition physiological states. When considering subjective evaluations, comfort was consistently rated higher, and the acute stress condition was rated lower on the air mattress, particularly at the start of the exposure. These findings indicate that enhanced load adaptability can improve perceived well-being without altering short-term physiological safety. This work highlights the potential of adaptive neonatal support surfaces to improve comfort and contribute to better patient outcomes. Trial registration: ClinicalTrials.gov, NCT06425068. Registered 11 April 2024, https://clinicaltrials.gov/ct2/show/NCT06425068 .