Division of Neonatology, Careggi University Hospital of Florence, Largo Brambilla, 3, Florence, 50141, Italy.
Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
Eur J Pediatr. 2024 Oct;183(10):4411-4416. doi: 10.1007/s00431-024-05674-5. Epub 2024 Aug 9.
Lung function has never been assessed during kangaroo mother care (KMC) in preterm infants. We measured lung (rSOL) and cerebral (rSOC) oxygenation by near-infrared spectroscopy (NIRS) in infants born at less than 32 weeks of gestation or weighing ≤ 1500 g during KMC. rSOL, rSOC, and pulmonary (FOEL) and cerebral (FOEC) tissue oxygen extraction fraction were measured in 20 preterm infants before, during, and after a 2-h period of KMC at a mean postnatal age of 36 ± 21 days of life. We found that rSOL, rSOC, FOEL, and FOEC did not change in our patients. After 120 min of KMC, rSOL was lower (71.3 ± 1.4 vs. 76.7 ± 4.6%; P = 0.012) in infants with BPD (n = 6; 30%) than in infants without BPD (n = 14 = 60%), while FOEL was higher (0.26 ± 0.02 vs. 0.20 ± 0.05; P = 0.012).Conclusion: Cerebral and lung oxygenation did not change in preterm infants during KMC. A transient decrease in lung oxygenation was offset by the increase in oxygen extraction, but these changes were clinically insignificant. These results confirm the safety of KMC in preterm infants who are in stable clinical conditions. What is Known • Kangaroo mother care (KMC) is widely used to improve the care of preterm newborns since it improves their outcome. • KMC is safe as patients' vital parameters, are not negatively affected, but lung function has never been directly assessed. What is New • Cerebral and lung oxygenation measured by near-infrared spectroscopy did not change during KMC. • A transient decrease in lung oxygenation compensated for by the increase in oxygen extraction occurred only in infants with BPD, but these changes were clinically insignificant.
袋鼠式护理（KMC）期间从未评估过早产儿的肺功能。我们通过近红外光谱（NIRS）测量了胎龄小于 32 周或出生体重≤1500g 的早产儿在 KMC 期间的肺部（rSOL）和大脑（rSOC）氧合。在出生后 36±21 天的平均年龄，20 名早产儿在进行 2 小时 KMC 之前、期间和之后测量了 rSOL、rSOC、肺部（FOEL）和大脑（FOEC）组织氧提取分数。我们发现，在我们的患者中，rSOL、rSOC、FOEL 和 FOEC 没有变化。在 KMC 120 分钟后，患有 BPD（n=6；30%）的婴儿 rSOL 低于（71.3±1.4 与 76.7±4.6%；P=0.012），而无 BPD（n=14=60%）的婴儿，而 FOEL 更高（0.26±0.02 与 0.20±0.05；P=0.012）。结论：在 KMC 期间，早产儿的大脑和肺部氧合没有变化。肺氧合的短暂下降被氧提取的增加所抵消，但这些变化在临床上没有意义。这些结果证实了在稳定临床情况下，KMC 对早产儿是安全的。已知：袋鼠式护理（KMC）被广泛用于改善早产儿的护理，因为它可以改善他们的结果。KMC 是安全的，因为患者的生命体征不受影响，但从未直接评估过肺功能。新内容：通过近红外光谱测量的大脑和肺部氧合在 KMC 期间没有变化。仅在患有 BPD 的婴儿中，才会出现肺氧合短暂下降，但这些变化在临床上无意义，这是由氧提取增加所补偿的。
