Hartley Caroline, Adjei Tricia, Chehrazi Mohammad, Baticula Joan, Andrzejewska Izabela, Hyde Matthew, Modi Neena, Jeffries Suzan
Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
Section of Neonatal Medicine, Faculty of Medicine, Chelsea and Westminster Hospital Campus, School of Public Health, Imperial College London, London, United Kingdom.
Front Pediatr. 2025 Apr 30;13:1532848. doi: 10.3389/fped.2025.1532848. eCollection 2025.
Infants who are born very preterm experience frequent episodes of physiological instability including apnoea, oxygen desaturation and bradycardia due to immaturity of the pulmonary and nervous systems. Parental contact, such as kangaroo care, may reduce physiological instability. However, there may be long periods when parents cannot be with their baby. The BABYBE SYSTEM® is a medical device designed to simulate kangaroo care.
We conducted a randomised cross-over trial to determine whether episodes of apnoea and other episodes of physiological instability were reduced when infants were on an active BABYBE mattress. Each infant was included in the study for five consecutive days, with successive 12-h periods of the BABYBE® mattress being switched on or off. Episodes of physiological instability were identified from recordings of the vital signs monitors and compared with clinical notes. Generalised estimating equations models were used to compare physiological instability when the BABYBE mattress was switched on vs. off.
A total of 23 infants born before 32 weeks' gestation were included in the main analysis. There was no significant difference between the number of apnoeic episodes infants experienced in the 12-h period when the BABYBE mattress was on compared with when the mattress was switched off (difference between conditions = 1.5 apnoeas, 95% CI: -0.2-3.2, = 0.09). The number of episodes of apnoea identified from vital signs recordings were much higher than those documented in the clinical records (a total of 1,157 apnoeic episodes were identified across all infants from vital signs recordings compared with a total of 27 documented in clinical/nursing notes of the same infants).
This trial does not provide evidence of a benefit of the BABYBE mattress for improving physiological stability in preterm infants. This study provides confirmation of the under-recognition of apnoeic episodes in clinical notes and the benefit of assessing electronic recordings of vital signs to gain a more complete picture of physiological stability.
由于肺部和神经系统发育不成熟，极早产婴儿经常出现生理不稳定情况，包括呼吸暂停、氧饱和度下降和心动过缓。父母的接触，如袋鼠式护理，可能会减少生理不稳定情况。然而，父母可能会有很长一段时间不能陪伴在婴儿身边。BABYBE SYSTEM®是一种旨在模拟袋鼠式护理的医疗设备。
我们进行了一项随机交叉试验，以确定婴儿使用激活状态的BABYBE床垫时，呼吸暂停发作及其他生理不稳定发作情况是否会减少。每个婴儿连续五天纳入研究，BABYBE®床垫连续12小时开启或关闭。从生命体征监测记录中识别出生理不稳定发作情况，并与临床记录进行比较。使用广义估计方程模型比较BABYBE床垫开启和关闭时的生理不稳定情况。
共有23名孕周小于32周出生的婴儿纳入主要分析。与床垫关闭时相比，婴儿在BABYBE床垫开启的12小时期间经历的呼吸暂停发作次数没有显著差异（不同状态之间的差异 = 1.5次呼吸暂停，95%置信区间：-0.2 - 3.2，P = 0.09）。从生命体征记录中识别出的呼吸暂停发作次数远高于临床记录中的次数（所有婴儿的生命体征记录中共识别出1157次呼吸暂停发作，而同一婴儿的临床/护理记录中仅记录了27次）。
该试验没有提供证据表明BABYBE床垫对改善早产儿生理稳定性有益。本研究证实了临床记录中对呼吸暂停发作认识不足，以及评估生命体征电子记录以更全面了解生理稳定性的益处。
