Padhi T R, Sareen D, Pradhan L, Jalali S, Sutar S, Das T, Modi R R, Behera U C
Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
Infosys Pediatric Center, Capital Hospital, Bhubaneswar, India.
Eye (Lond). 2015 Apr;29(4):505-8. doi: 10.1038/eye.2014.340. Epub 2015 Jan 23.
To evaluate retinopathy of prematurity (ROP) screening practice in reverse Kangaroo Mother Care (R-KMC) with respect to stress and pain to the infant.
In a pilot study we evaluated ROP screening practice in R-KMC in 20 babies at risk of ROP. The R-KMC differed from the conventional KMC with respect to the baby position where the baby lay supine on mother's chest. With the mother lying supine and the baby in R-KMC position, screening examinations were done with indirect ophthalmoscope. The outcome measures included stress (quantified by pulse, respiration, and oxygen saturation) and pain to the baby by observing facial expression (eye squeezing, crying, and brow bulge). The heart rate, respiratory rate, and SpO2 (%) were compared before and immediately after the procedure using paired t-test.
Mean (±SD) gestational age and birth weight were 30.8±2.3 weeks and 1362.5±253.9 g, respectively. During examination in R- KMC position 8 babies (40%) were completely relaxed (no eye squeezing and crying), 10 (50%) were partially relaxed (no brow bulge) and 2 babies (10%) were not relaxed. A change in heart and respiration rate both by 10 per minute was recorded in 12 (60%) and 10 (50%) babies, respectively. Five babies (25%) had reduction in blood oxygen concentration below 92%. The majority of the mothers (19 of 20) were relaxed.
ROP screening in R-KMC can be a baby friendly screening practice with respect to stress and pain to the infant and needs further evaluation in a larger cohort.
评估反向袋鼠式护理（R-KMC）中早产儿视网膜病变（ROP）筛查操作对婴儿造成的压力和疼痛。
在一项试点研究中，我们对20名有ROP风险的婴儿进行了R-KMC中的ROP筛查操作评估。R-KMC与传统袋鼠式护理的不同之处在于婴儿的姿势，即婴儿仰卧在母亲胸前。母亲仰卧，婴儿处于R-KMC姿势时，使用间接检眼镜进行筛查检查。结果指标包括压力（通过脉搏、呼吸和血氧饱和度量化）以及通过观察面部表情（挤眼、哭闹和皱眉）来评估对婴儿造成的疼痛。使用配对t检验比较操作前和操作后即刻的心率、呼吸频率和血氧饱和度（%）。
平均（±标准差）胎龄和出生体重分别为30.8±2.3周和1362.5±253.9克。在R-KMC姿势检查期间，8名婴儿（40%）完全放松（无挤眼和哭闹），10名婴儿（50%）部分放松（无皱眉），2名婴儿（10%）未放松。分别有12名（60%）和10名（50%）婴儿的心率和呼吸频率每分钟变化10次。5名婴儿（25%）的血氧浓度降至92%以下。大多数母亲（20名中的19名）很放松。
就对婴儿造成的压力和疼痛而言，R-KMC中的ROP筛查可以是一种对婴儿友好的筛查操作，需要在更大的队列中进行进一步评估。
