Lorenz Laila, Dawson Jennifer A, Jones Hannah, Jacobs Susan E, Cheong Jeanie L, Donath Susan M, Davis Peter G, Kamlin C Omar F
Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.
Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Germany.
Arch Dis Child Fetal Neonatal Ed. 2017 Jul;102(4):F339-F344. doi: 10.1136/archdischild-2016-311752. Epub 2017 Jan 17.
Providing skin-to-skin care (SSC) to preterm infants is standard practice in many neonatal intensive care units. There are conflicting reports on the stability of oxygen saturation (SpO) during SSC, which may create a barrier to a wider implementation of SSC to infants receiving respiratory support. Regional cerebral oxygenation (rcO) measured using near-infrared spectroscopy can serve as a surrogate parameter for cerebral oxygen delivery and consumption. We hypothesised that rcO during SSC would be similar to standard care in preterm infants receiving respiratory support.
Prospective observational non-inferiority study.
Single tertiary perinatal centre in Australia.
Forty preterm infants (median (IQR) of 27.6 (26.0-28.9) weeks' gestation) receiving respiratory support were studied on day 8 (5-18).
Ninety minutes of SSC, with infants in incubators acting as their own control. Parents and caregivers were blinded to the measurements.
Mean difference in rcO between SSC and incubator care; as well as heart rate (HR), SpO, fraction of inspired oxygen (FiO) and temperature, were compared using a paired t-test.
rcO was similar during SSC (mean (SD) 74.9 (6.5)%)% compared with incubator care (74.7 (6.1)%, mean difference (95% CI) 0.2 (-0.8 to 1.1)%, p=0.71). No clinically important differences in HR, SpO, FiO or temperature were observed in the whole cohort and by mode of respiratory support (endotracheal tube mechanical ventilation, continuous positive airway pressure and high-flow nasal cannulae).
Cerebral oxygenation and other physiological measurements in ventilated preterm infants did not differ between SSC and incubator care.
12615000959572.
在许多新生儿重症监护病房，为早产儿提供肌肤接触护理（SSC）是标准做法。关于SSC期间血氧饱和度（SpO）稳定性的报道相互矛盾，这可能会阻碍SSC在接受呼吸支持的婴儿中更广泛地实施。使用近红外光谱测量的局部脑氧合（rcO）可作为脑氧输送和消耗的替代参数。我们假设，接受呼吸支持的早产儿在SSC期间的rcO与标准护理相似。
前瞻性观察性非劣效性研究。
澳大利亚的一家三级围产期中心。
对40名接受呼吸支持的早产儿（孕龄中位数（四分位间距）为27.6（26.0 - 28.9）周）在第8天（5 - 18天）进行了研究。
进行90分钟的SSC，置于暖箱中的婴儿作为自身对照。家长和护理人员对测量结果不知情。
比较SSC和暖箱护理期间rcO的平均差异；以及心率（HR）、SpO、吸入氧分数（FiO）和体温，采用配对t检验。
与暖箱护理相比，SSC期间rcO相似（平均值（标准差）为74.9（6.5）%），暖箱护理为74.7（6.1）%，平均差异（95%置信区间）为0.2（-0.8至1.1）%，p = 0.71）。在整个队列以及按呼吸支持模式（气管插管机械通气、持续气道正压通气和高流量鼻导管吸氧）分析时，未观察到HR、SpO、FiO或体温有临床意义的差异。
接受通气的早产儿在SSC和暖箱护理期间，脑氧合及其他生理测量结果无差异。
12615000959572。
