Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Vic., Australia.
University of Melbourne, Melbourne, Vic., Australia.
Acta Paediatr. 2018 Mar;107(3):430-435. doi: 10.1111/apa.14158. Epub 2017 Dec 22.
To describe cerebral oxygenation during gavage feeding of preterm infants during incubator and skin-to-skin care.
Further analysis of data from two crossover studies comparing cerebral oxygenation, heart rate and oxygen saturation during skin-to-skin care with incubator care. Data were analysed in three epochs; 10 minutes prefeed, during-feed and 10 minutes postfeed. Measurements from infants fed during incubator care were compared with those obtained during skin-to-skin care.
In 39 infants [median (IQR) 27.8 (26.1-30.0) weeks' gestation], there was no difference in cerebral oxygenation between pre-, during- and postfeed. Heart rate increased by three beats per minute postfeed compared with during-feed. Twenty infants received two gavage feeds, one feed in the incubator and another during skin-to-skin care. There was no difference in cerebral oxygenation and heart rate; peripheral oxygen saturation decreased by 3% during feeding whilst skin-to-skin care compared with feeding in the incubator.
Cerebral oxygenation remained stable before, during and after gavage feeding in an incubator and during skin-to-skin care. The small decrease in oxygen saturation whilst receiving gavage feeding during skin-to-skin care is unlikely to be clinically important, providing reassurance that preterm infants maintain physiological stability during skin-to-skin care.
描述早产儿在保温箱和皮肤接触护理时进行胃管喂养期间的脑氧合情况。
对两项交叉研究数据的进一步分析，比较皮肤接触护理与保温箱护理期间的脑氧合、心率和氧饱和度。数据在三个时期进行分析：喂养前 10 分钟、喂养期间和喂养后 10 分钟。将在保温箱中喂养的婴儿的测量值与皮肤接触护理时获得的测量值进行比较。
在 39 名婴儿[中位数（IQR）27.8（26.1-30.0）周龄]中，喂养前、喂养中和喂养后的脑氧合没有差异。与喂养期间相比，喂养后心率每分钟增加 3 次。20 名婴儿接受了两次胃管喂养，一次在保温箱中，另一次在皮肤接触护理时。脑氧合和心率没有差异；与在保温箱中喂养相比，皮肤接触护理时的外周氧饱和度在喂养期间下降了 3%。
在保温箱中进行胃管喂养以及皮肤接触护理期间，脑氧合在喂养前、喂养中和喂养后保持稳定。在皮肤接触护理时进行胃管喂养期间，氧饱和度略有下降，但不太可能具有临床意义，这为早产儿在皮肤接触护理期间保持生理稳定提供了保证。
