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Effects of semi-upright swings on vital signs in NICU infants



The aim of this study was to compare the impact of a semi-upright swing with a standard crib on vital signs in infants in the neonatal intensive care unit (NICU).


We performed a within-subjects’ comparison of vital signs of NICU infants corrected to ≥34 weeks of gestation and placed in the supine position versus the semi-upright position in a swing. The primary outcome was the mean oxygen saturation, and the secondary outcomes were the mean heart rate, the proportion of time with oxygen saturation (SpO2) <90%, and respiratory rate.


Of the 65 infants, 34 (57%) were male and 32 (50%) were black. The mean ± SD gestational age at birth was 32.4 ± 5.1 weeks. In all, 40% were on noninvasive respiratory support. There were no significant differences in oxygen saturation, heart rate, time with oxygen desaturation defined by SpO2 < 90%, or respiratory rate between the supine and semi-upright positions. A higher risk of desaturations was observed in infants without respiratory support (RR, 1.24, 95% CI, 1.15–1.33) and low-birth-weight infants (RR, 1.55, 95% CI, 1.42–1.69).


The placement of infants in a semi-upright swing resulted in no discernible differences in averaged vital signs compared to the supine position in NICU infants.


  • We identified no significant differences in averaged oxygen saturation, heart rate, or respiratory rate among NICU infants placed in a semi-upright swing compared to the supine position.

  • Desaturation events occurred at a higher frequency in low-birth-weight infants and those on room air when placed in the swing, although none required oxygen supplementation.

  • The results from the current study support that it is probably safe to use semi-upright swings in the NICU environment, although additional studies are necessary for generalization to the unmonitored home environment.

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Fig. 1: Summary of changes in vital signs in infants placed in the swing compared to the crib.
Fig. 2: Summary of subgroup effects related to the changes in vital signs in infants placed in the swing compared to the crib.
Fig. 3: Summary of temporal trends in oxygen saturation and heart rate in the crib and the swing.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.


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We thank Dr. Natalie Davis for feedback on an earlier version of the manuscript. We also thank Johnnie Chan for assistance with downloading bedside telemetry data.

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Authors and Affiliations



S.K. conceptualized and designed the study, collected data, drafted the initial manuscript, and reviewed and revised the manuscript. A.I. performed and interpreted the data analyses and reviewed and revised the manuscript. D.E.-M. conceptualized and designed the study, coordinated, and supervised data collection and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Dina El-Metwally.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study protocol was approved by the local Institutional Review Board. Parents of all subjects gave written consent to participate in the study.

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Kadakia, S., Isaiah, A. & El-Metwally, D. Effects of semi-upright swings on vital signs in NICU infants. Pediatr Res 93, 953–958 (2023).

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