Meder Unoke, Tarjanyi Eszter, Kovacs Kata, Szakmar Eniko, Cseko Anna Judit, Hazay Timea, Belteki Gusztav, Szabo Miklos, Jermendy Agnes
1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Neonatal Intensive Care Unit, The Rosie Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Pediatr Res. 2021 Oct;90(4):809-814. doi: 10.1038/s41390-020-01235-2. Epub 2020 Dec 1.
Our aim was to investigate the effect of music therapy in combination with skin-to-skin care (SSC) on regional cerebral oxygenation (rSO) measured with near-infrared spectroscopy (NIRS) in premature infants and to study physiological stability during the interventions.
This was a prospective single-center observational cohort study conducted in a tertiary neonatal intensive care unit. The study consisted of four phases: (1) baseline measurements in an incubator for 30 min; (2) quiet SSC for 30 min (SSC-Pre); (3) SSC with live maternal singing accompanied by live guitar music for 20 min (SSC-Music); (4) final quiet SSC for another 30 min (SSC-Post).
The primary outcome measure of mean rSO for the 31 preterm infants analyzed showed a significant increase from baseline during SSC-Music (76.87% vs 77.74%, p = 0.04) and SSC-Post (76.87% vs 78.0%, p = 0.03) phases. There were no significant changes observed in heart rate (HR), peripheral oxygen saturation (SpO), and cerebral fractional tissue oxygen extraction (cFTOE). The coefficient of variation (CV) of rSO and SpO decreased during each intervention phase.
Combining music therapy with SSC appears to be safe in preterm neonates. The impact of the small increase in rSO and reduced variability of SpO and rSO warrants further investigation.
Music therapy combined with skin-to-skin care (SSC) is safe in clinically stable premature infants and could be encouraged as part of developmental care. This is the first report where near-infrared spectroscopy (NIRS) was used to detect the simultaneous effect of music therapy and SSC on cerebral rSO in preterm infants. Music therapy with SSC caused a modest increase in rSO and decreased the coefficient of variation of rSO and peripheral oxygen saturation (SpO), which suggest short-term benefits for preterm infants.
我们的目的是研究音乐疗法联合肌肤相亲护理（SSC）对早产儿近红外光谱（NIRS）测量的局部脑氧合（rSO）的影响，并研究干预期间的生理稳定性。
这是一项在三级新生儿重症监护病房进行的前瞻性单中心观察性队列研究。该研究包括四个阶段：（1）在暖箱中进行30分钟的基线测量；（2）安静的肌肤相亲护理30分钟（SSC-预）；（3）母亲现场唱歌并伴有现场吉他音乐的肌肤相亲护理20分钟（SSC-音乐）；（4）再进行30分钟的最终安静肌肤相亲护理（SSC-后）。
对31名早产儿分析的主要结局指标平均rSO显示，在SSC-音乐阶段（76.87%对77.74%，p = 0.04）和SSC-后阶段（76.87%对78.0%，p = 0.03），与基线相比有显著增加。心率（HR）、外周血氧饱和度（SpO）和脑分数组织氧摄取（cFTOE）未观察到显著变化。在每个干预阶段，rSO和SpO的变异系数（CV）降低。
音乐疗法联合SSC对早产儿似乎是安全的。rSO的小幅增加以及SpO和rSO变异性降低的影响值得进一步研究。
音乐疗法联合肌肤相亲护理（SSC）对临床稳定的早产儿是安全的，可作为发育性护理的一部分加以鼓励。这是首次使用近红外光谱（NIRS）检测音乐疗法和SSC对早产儿脑rSO的同时影响的报告。音乐疗法联合SSC使rSO适度增加，并降低了rSO和外周血氧饱和度（SpO）的变异系数，这表明对早产儿有短期益处。
