Objectives To evaluate whether kangaroo mother care (KMC) in preterm infants on non-invasive respiratory support improves indices of cardiorespiratory wellbeing. Study design Prospective quasi-experimental observational study. Setting Tertiary perinatal neonatal unit. Patients 50 very preterm infants being managed with nasal continuous positive airway pressure. Interventions Continuous high-resolution preductal pulse-oximetry recordings using Masimo Radical-7 oximeter for 1 hour (incubator care) followed by 1 hour during KMC performed on the same day. Main outcome measures Measures of cardiorespiratory stability (dips in oxygen saturations (SpO2)) of ≥5% less than baseline, % time spent with oxygen saturations <90%, SpO2 variability and heart rate fluctuation and incidence of bradycardias. Results The gestational age and birth weight of the cohort were 28.4±2.1 weeks and 1137±301 g, respectively. Dips in SpO2 of ≥5% less than baseline were significantly fewer with KMC, median (IQR) 24 (12 to 42) vs 13 (3 to 25), p=0.001. SpO2 variability (Delta 12 s and 2 s), (1.24±0.6 vs 0.9±0.4, p=0.005 and 4.1±1.7 vs 2.8±1.2, p<0.0001) and rapid resaturation and desaturation indices were significantly lower during KMC, compared with incubator care. Percentage time spent in oxygen saturations <90% was less with KMC (7.5% vs 2.7%, p=0.04). Mean heart rate was comparable although fluctuations in heart rate (rise by >8 bpm) were lower with KMC (43±22 vs 33±20, p=0.03). Seven (14%) infants had bradycardias during incubator care and none during KMC, p=0.012. Conclusions KMC improves cardiorespiratory stability in ventilated preterm infants. Regular KMC has the potential to improve clinical outcomes in this vulnerable cohort. Data sharing not applicable as no datasets generated and/or analysed for this study.

中文翻译：

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袋鼠妈妈护理改善早产儿心肺生理机能：一项观察性研究

目的 评估采用无创呼吸支持的袋鼠妈妈式护理 (KMC) 是否可以改善早产儿的心肺健康指数。研究设计前瞻性准实验观察研究。设置第三级围产期新生儿病房。患者中有 50 名极早产儿，正在接受经鼻持续气道正压通气治疗。干预措施 使用 Masimo Radical-7 血氧计连续进行高分辨率导管前脉搏血氧测定记录 1 小时（培养箱护理），然后在同一天进行的 KMC 期间进行 1 小时记录。主要结局指标 心肺稳定性指标（氧饱和度 (SpO2) 下降）比基线低 ≥5%、氧饱和度 <90% 所花费的时间百分比、SpO2 变异性和心率波动以及心动过缓发生率。结果 该队列的胎龄和出生体重分别为28.4±2.1周和1137±301 g。 KMC 组的 SpO2 下降幅度比基线低 ≥5% 的情况显着减少，中位 (IQR) 为 24（12 至 42）vs 13（3 至 25），p=0.001。与 KMC 期间相比，SpO2 变异性（Delta 12 s 和 2 s）（1.24±0.6 vs 0.9±0.4，p=0.005 和 4.1±1.7 vs 2.8±1.2，p<0.0001）以及快速再饱和和去饱和指数显着降低孵化器护理。使用 KMC 时，血氧饱和度 <90% 所花费的时间百分比较少（7.5% vs 2.7%，p=0.04）。尽管 KMC 组心率波动（上升 > 8 bpm）较低，但平均心率相当（43±22 vs 33±20，p=0.03）。七名 (14%) 婴儿在保温箱护理期间出现心动过缓，而在 KMC 期间没有出现心动过缓，p=0.012。结论 KMC 可改善通气早产儿的心肺稳定性。定期 KMC 有可能改善这一弱势群体的临床结果。数据共享不适用，因为本研究没有生成和/或分析数据集。