Kangaroo mother care improves cardiorespiratory physiology in preterm infants: an observational study.

IF 3.9 2区 医学 Q1 PEDIATRICS
Arvind Sehgal, Emma J Yeomans, Gillian M Nixon
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引用次数: 0

Abstract

Objectives: To evaluate whether kangaroo mother care (KMC) in preterm infants on non-invasive respiratory support improves indices of cardiorespiratory wellbeing.

Study design: Prospective quasi-experimental observational study.

Setting: Tertiary perinatal neonatal unit.

Patients: 50 very preterm infants being managed with nasal continuous positive airway pressure.

Interventions: Continuous high-resolution preductal pulse-oximetry recordings using Masimo Radical-7 oximeter for 1 hour (incubator care) followed by 1 hour during KMC performed on the same day.

Main outcome measures: Measures of cardiorespiratory stability (dips in oxygen saturations (SpO2)) of ≥5% less than baseline, % time spent with oxygen saturations <90%, SpO2 variability and heart rate fluctuation and incidence of bradycardias.

Results: The gestational age and birth weight of the cohort were 28.4±2.1 weeks and 1137±301 g, respectively. Dips in SpO2 of ≥5% less than baseline were significantly fewer with KMC, median (IQR) 24 (12 to 42) vs 13 (3 to 25), p=0.001. SpO2 variability (Delta 12 s and 2 s), (1.24±0.6 vs 0.9±0.4, p=0.005 and 4.1±1.7 vs 2.8±1.2, p<0.0001) and rapid resaturation and desaturation indices were significantly lower during KMC, compared with incubator care. Percentage time spent in oxygen saturations <90% was less with KMC (7.5% vs 2.7%, p=0.04). Mean heart rate was comparable although fluctuations in heart rate (rise by >8 bpm) were lower with KMC (43±22 vs 33±20, p=0.03). Seven (14%) infants had bradycardias during incubator care and none during KMC, p=0.012.

Conclusions: KMC improves cardiorespiratory stability in ventilated preterm infants. Regular KMC has the potential to improve clinical outcomes in this vulnerable cohort.

袋鼠妈妈护理可改善早产儿的心肺生理机能:一项观察性研究。
研究目的评估袋鼠妈妈护理(KMC)是否能改善接受无创呼吸支持的早产儿的心肺功能指数:前瞻性准实验观察研究:环境:三级围产期新生儿病房:50名接受鼻持续气道正压治疗的早产儿:干预措施:使用 Masimo Radical-7 血氧仪连续记录高分辨率导管前脉搏血氧饱和度 1 小时(保温箱护理),然后在同一天进行 KMC 期间记录 1 小时:主要结果测量:心肺稳定性(血氧饱和度(SpO2)比基线下降≥5%)、血氧饱和度2变异性和心率波动时间百分比以及心动过缓发生率:胎龄和出生体重分别为 28.4±2.1 周和 1137±301 克。与基线相比,SpO2下降≥5%的情况在KMC中明显较少,中位数(IQR)为24(12-42)对13(3-25),P=0.001。KMC 的 SpO2 变异性(Delta 12 秒和 2 秒)更低(1.24±0.6 vs 0.9±0.4,p=0.005;4.1±1.7 vs 2.8±1.2,p8 bpm)(43±22 vs 33±20,p=0.03)。7名(14%)婴儿在保温箱护理期间出现心动过缓,而在 KMC 期间没有,P=0.012:KMC 可改善通气早产儿的心肺稳定性。定期进行 KMC 有可能改善这一脆弱群体的临床预后。
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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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