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极低出生体重早产儿袋鼠式护理期间的生理稳定性,由无创呼吸支持提供支持。

Physiological Stability During Kangaroo Mother Care Among Very-Low-Birthweight Premature Infants, Supported by Non-Invasive Respiratory Support.

作者信息

Harari Jhonatan, Riskin Arieh, Titarchuk Julia, Iofe Adir, Hochwald Ori, Borenstein-Levin Liron

机构信息

Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.

Neonatal Intensive Care Unit, Rambam Health Care Campus, Haifa, Israel.

出版信息

J Paediatr Child Health. 2025 Jul 22. doi: 10.1111/jpc.70153.

Abstract

AIM

To evaluate the changes in oxygenation and heart rate (HR) stability among very low birth weight (VLBW) premature infants supported by non-invasive ventilation (NIV) during kangaroo mother care (KMC).

METHODS

A prospective observational pilot study. 30-min SpO and HR histograms of VLBW infants supported with NIV were documented before, during, and after KMC. A validated classification system was used to classify each histogram as stable/unstable, based on the distribution of the histogram and the time spent in SpO ≤ 80%. Time spent in different SpO ranges was also calculated from the histogram.

RESULTS

Twenty-seven infants were included in the study (mean ± SD gestational age 27.6 ± 1.7, birth weight 1010 ± 237 g). Oxygenation stability and time spent in different SpO ranges before, during, and after KMC were comparable. Infants spent more time within the normal HR range of 120-160 bpm during KMC as compared to the period before. No clinically significant differences in min-max FiO, number of apnea events, or body temperature were observed during the three study periods.

CONCLUSION

During KMC among VLBW premature infants supported by NIV, oxygenation stability was maintained and HR stability improved. These findings should reassure care teams and parents regarding the safety of KMC among this population.

摘要

目的

评估极低出生体重(VLBW)早产儿在袋鼠式护理(KMC)期间接受无创通气(NIV)支持时的氧合变化和心率(HR)稳定性。

方法

一项前瞻性观察性试点研究。记录VLBW婴儿在KMC之前、期间和之后接受NIV支持时的30分钟血氧饱和度(SpO)和心率直方图。基于直方图的分布以及SpO≤80%所花费的时间,使用经过验证的分类系统将每个直方图分类为稳定/不稳定。还从直方图中计算出在不同SpO范围内所花费的时间。

结果

27名婴儿纳入研究(平均胎龄±标准差27.6±1.7,出生体重1010±237克)。KMC之前、期间和之后的氧合稳定性以及在不同SpO范围内所花费的时间具有可比性。与之前相比,婴儿在KMC期间处于120 - 160次/分钟正常心率范围内的时间更长。在三个研究期间,未观察到最低 - 最高吸入氧浓度(FiO)、呼吸暂停事件数量或体温的临床显著差异。

结论

在接受NIV支持的VLBW早产儿的KMC期间,氧合稳定性得以维持,心率稳定性得到改善。这些发现应能让护理团队和家长放心KMC在此类人群中的安全性。

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