医学
心肺适能
胎龄
心率
孵化器
脉搏血氧仪
持续气道正压
氧饱和度
观察研究
儿科
呼吸频率
前瞻性队列研究
麻醉
心脏病学
内科学
血压
氧气
怀孕
有机化学
化学
遗传学
阻塞性睡眠呼吸暂停
微生物学
生物
作者
Arvind Sehgal,Emma Yeomans,Gillian M. Nixon
标识
DOI:10.1136/archdischild-2023-326748
摘要
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 (SpO 2 )) of ≥5% less than baseline, % time spent with oxygen saturations <90%, SpO 2 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 SpO 2 of ≥5% less than baseline were significantly fewer with KMC, median (IQR) 24 (12 to 42) vs 13 (3 to 25), p=0.001. SpO 2 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.
科研通智能强力驱动
Strongly Powered by AbleSci AI