Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
Department of Neonatology, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India.
Am J Perinatol. 2022 Dec;39(16):1796-1804. doi: 10.1055/s-0041-1726126. Epub 2021 Mar 23.
This research aimed to study the impact of early parent participation program (EPPP) for preterm infants in neonatal intensive care unit (NICU) on physiological instability, breastmilk feeding rates, and discharge timing.
Families of 147 infants born between 28 and 33 weeks' gestation were randomized at birth to EPPP group or conventional care (CC). Families in the EPPP group were trained soon after admission by using a structured education program and encouraged to spend more time with their baby. Soon after enrolment (day of life 1 to 2), they would sequentially participate in daily NICU care processes such as orogastric tube feeding, nesting, oil massages, diaper changes, and daily weight checks. Families in the CC group would undergo the same after their infant was off parenteral nutrition and respiratory support. Proportion of infants having physiological instability (significant apnea, feeding intolerance, or needing investigation for sepsis) in two groups was compared.
There was a significant reduction in the proportion of infants with physiological instability (feeding intolerance) in the EPPP group (relative risk = 0.70 [0.52-0.94], = 0.016). Infants in EPPP group had a trend toward higher breastmilk feeding rates at discharge (66 vs. 51%, = 0.076).
Very early parent participation was feasible in the NICU and led to decrease in physiological instability in preterm infants.
· Family-integrated care is beneficial; however, it is often started later in the NICU course.. · This trial showed that very early involvement of family in NICU care processes is feasible and safe.. · Structured parent participation started very early improves physiological stability in preterm infants (mainly tolerance to feeds)..
本研究旨在探讨新生儿重症监护病房（NICU）中早产儿早期父母参与方案（EPPP）对生理不稳定、母乳喂养率和出院时间的影响。
将 147 名胎龄 28 至 33 周出生的婴儿的家庭在出生时随机分为 EPPP 组或常规护理（CC）组。EPPP 组的家庭在入院后不久即通过结构化教育计划接受培训，并鼓励他们与婴儿共度更多时间。在入组后不久（第 1 至 2 天），他们将依次参与每日 NICU 护理过程，如经口胃管喂养、巢式护理、油按摩、尿布更换和每日体重检查。CC 组的家庭在婴儿停止肠外营养和呼吸支持后会进行同样的操作。比较两组中出现生理不稳定（明显呼吸暂停、喂养不耐受或需要进行败血症检查）的婴儿比例。
EPPP 组中出现生理不稳定（喂养不耐受）的婴儿比例显著降低（相对风险=0.70[0.52-0.94]，=0.016）。EPPP 组的婴儿在出院时母乳喂养率有升高的趋势（66%比 51%，=0.076）。
在 NICU 中非常早地让父母参与是可行的，这可导致早产儿的生理不稳定减少。
·家庭综合护理是有益的，但通常在 NICU 病程的后期开始。·本试验表明，非常早地让家庭参与 NICU 护理过程是可行且安全的。·早期开始的结构化父母参与可改善早产儿的生理稳定性（主要是对喂养的耐受性）。
