INTRODUCTION We aimed to investigate the cerebral fractional tissue oxygen extraction (FtOE) during kangaroo care (KC) in premature infants and compare cardiorespiratory stability and hypoxic or bradycardic events between KC and incubator care. METHODS A single-center prospective observational study was carried out at the NICU of a level 3 perinatal center. Preterm infants <32 weeks gestational age were subjected to KC. Patients were subjected to continuous monitoring of regional cerebral oxygen saturation (rScO2), peripheral oxygen saturation (SpO2), and heart rate (HR) during KC, before KC (pre-KC), and after KC (post-KC). The monitoring data were stored and exported to MATLAB for synchronization and signal analysis including the calculation of the FtOE and events analysis (i.e., desaturations and bradycardias counts and anormal values). Furthermore, the event counts and the mean SpO2, HR, rScO2, and FtOE were compared between studied periods employing the Wilcoxon rank-sum test and the Friedman test, respectively. RESULTS A total of forty-three KC sessions with their corresponding pre-KC and post-KC segments were analyzed. The distributions of the SpO2, HR, rScO2, and FtOE showed different patterns according to the respiratory support, but not differences between the studied periods were detected. Accordingly, no significant differences in monitoring events were evidenced. However, cerebral metabolic demand (FtOE) was significantly lower during KC compared with post-KC (p = 0.019). CONCLUSION Premature infants remain clinically stable during KC. Moreover, cerebral oxygenation is significantly higher and cerebral tissular oxygen extraction is significantly lower during KC compared with incubator care in post-KC. No differences in HR and SpO2 were shown. This novel data analysis methodology could be expanded to other clinical situations.

中文翻译：

---

袋鼠护理期间早产儿脑氧提取分数分析。

简介 我们的目的是调查早产儿袋鼠护理 (KC) 期间的脑组织氧提取分数 (FtOE)，并比较 KC 和保温箱护理之间的心肺稳定性和缺氧或心动过缓事件。方法在三级围产中心NICU进行单中心前瞻性观察研究。胎龄 <32 周的早产儿接受 KC。在 KC 期间、KC 前（KC 前）和 KC 后（KC 后）持续监测患者的局部脑氧饱和度 (rScO2)、外周血氧饱和度 (SpO2) 和心率 (HR)。监测数据被存储并导出到 MATLAB 以进行同步和信号分析，包括 FtOE 的计算和事件分析（即去饱和度和心动过缓计数以及异常值）。此外，分别采用 Wilcoxon 秩和检验和 Friedman 检验对研究期间的事件计数以及平均 SpO2、HR、rScO2 和 FtOE 进行比较。结果 总共分析了 43 个 KC 会话及其相应的 KC 前和 KC 后部分。根据呼吸支持的不同，SpO2、HR、rScO2 和 FtOE 的分布呈现出不同的模式，但未检测到研究期间之间的差异。因此，监测事件没有发现显着差异。然而，与 KC 后相比，KC 期间的脑代谢需求 (FtOE) 显着降低 (p = 0.019)。结论 早产儿在 KC 期间保持临床稳定。此外，与 KC 后的保温箱护理相比，KC 期间的脑氧合显着较高，脑组织氧提取显着较低。HR 和 SpO2 没有显示差异。这种新颖的数据分析方法可以扩展到其他临床情况。