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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.
- Neonatology
- Nursing Care
Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study.
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Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study.
Footnotes
Contributors AS: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; wrote the first draft and edited later versions; approve the final version and will be accountable for all aspects of the work. EJY: contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; critically revised the draft manuscript; approve the final version and will be accountable for all aspects of the work. GN: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; important input into editing the draft manuscript; approve the final version and will be accountable for all aspects of the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer-reviewed.
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