Montaner-Ramon Alicia, Carrillo-Messa Elena, Merayo-Fernandez Laura, Cosmo-Garcia Inmaculada, Ramos-Soriano Isabel, Gonzalez-Garcia Laura, Camba-Longueira Fatima
Neonatology Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Am J Perinatol. 2025 Feb;42(3):409-414. doi: 10.1055/a-2381-9050. Epub 2024 Aug 7.
For many health care providers, an umbilical venous catheter (UVC) may be a contraindication for skin-to-skin contact (SSC). Our aim was to compare the frequency of adverse events between preterm infants who were on SSC with UVC and those who remained in an incubator.
Prospective observational study in newborns less than 35 weeks gestation. UVC-related adverse events were compared between neonates who performed SSC and those who did not. The incidence of catheter-related displacement, leak, loss, hemorrhage, malfunction, and bloodstream infection was studied.
From 226 patients, 171 performed SSC with UVC. Their first contact was earlier than in those who remained in an incubator (SSC-UVC, 29 hours [interquartile range (IQR): 21-53] vs. no SSC-UVC, 132 hours [IQR: 96-188]; < 0.001). Both groups were similar in gestational age (SSC-UVC, 30 weeks vs. no SSC-UVC, 30.3 weeks; = 0.331) and birth weight (SSC-UVC, 1,285 g vs. no SSC-UVC, 1,355 g; = 0.2). Studied complications were not more frequent in patients who performed SSC. In fact, although it was not statistically significant, a lower overall incidence of adverse events (SSC-UVC, 13.5% vs. no SSC-UVC, 20%; = 0.237) and catheter-related bloodstream infection (SSC-UVC, 4.7% vs. no SSC-UVC, 10.9%; = 0.111) was observed in this group.
SSC with a UVC is a safe procedure and there are no more complications in newborns who perform SSC compared to those who remain in the incubator. Due to its demonstrated benefits, SSC should be promoted in premature newborns regardless of the presence of a UVC.
· SSC in preterm infants with UVCs is safe.. · Early SSC does not increase UVC-related bloodstream infection.. · Early SSC should be promoted in stable patients regardless of the presence of a UVC..
对于许多医护人员而言,脐静脉导管(UVC)可能是皮肤接触(SSC)的禁忌证。我们的目的是比较使用UVC进行SSC的早产儿与留在暖箱中的早产儿不良事件的发生频率。
对孕周小于35周的新生儿进行前瞻性观察研究。比较进行SSC的新生儿与未进行SSC的新生儿与UVC相关的不良事件。研究导管相关移位、渗漏、丢失、出血、故障和血流感染的发生率。
在226例患者中,171例使用UVC进行了SSC。他们的首次接触时间早于留在暖箱中的患者(使用UVC进行SSC组,29小时[四分位间距(IQR):21 - 53],未使用UVC进行SSC组,132小时[IQR:96 - 188];<0.001)。两组在孕周(使用UVC进行SSC组,30周,未使用UVC进行SSC组,30.3周;=0.331)和出生体重(使用UVC进行SSC组,1285克,未使用UVC进行SSC组,1355克;=0.2)方面相似。在进行SSC的患者中,所研究的并发症并不更频繁。事实上,虽然无统计学意义,但该组观察到不良事件的总体发生率较低(使用UVC进行SSC组,13.5%,未使用UVC进行SSC组,20%;=0.237),导管相关血流感染发生率也较低(使用UVC进行SSC组,4.7%,未使用UVC进行SSC组,10.9%;=0.111)。
使用UVC进行SSC是一种安全的操作,与留在暖箱中的新生儿相比,进行SSC的新生儿并发症并不更多。鉴于其已证实的益处,无论是否存在UVC,都应在早产新生儿中推广SSC。
· 使用UVC的早产儿进行SSC是安全的。· 早期SSC不会增加与UVC相关的血流感染。· 无论是否存在UVC,对于病情稳定的患者都应推广早期SSC。