Cot-nursing versus incubator care for preterm infants

Objective: The aim of this study was to analyze the randomised controlled trials that explored the effect of kangaroo mother care on physiological stress parameters of premature infants. Methods: Two independent researchers performed a systematic review of indexed studies in PubMed, Embase, CINAHL, Cochrane and Scopus. We included data from randomized controlled trials measuring the effects of kangaroo care compared to standard incubator care on physiological stress outcomes, defined as oxygen saturation, body temperature, heart rate and respiratory rate. The PRISMA model was used to conduct data extraction. We performed a narrative synthesis of all studies and a meta-analysis when data were available from multiple studies that compared the same physiological parameters with the kangaroo method as an intervention and controls and used the same outcome measures. Results: Twelve studies were eligible for inclusion in this meta-analysis. According to statistical analysis, the mean respiratory rate of preterm infants receiving KMC was lower than that of infants receiving standard incubator care (MD, −3.50; 95% CI, −5.17 to −1.83; p < 0.00001). Infants who received kangaroo mother care had a higher mean heart rate, oxygen saturation and temperature, although these results were not statistically significant. Conclusions: Current evidence suggests that kangaroo care in the neonatal intensive care unit setting is a safe method that may have a significant effect on some of the physiological parameters of stress in preterm infants. However, due to clinical heterogeneity, further studies are needed to assess the effects of physiological stress in the neonatal intensive care unit on the development of preterm infants.

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Randomized Crossover Trial of Kangaroo Care to Reduce Biobehavioral Pain Responses in Preterm Infants: A Pilot Study

Biological Research For Nursing ◽

10.1177/1099800410385839 ◽

2010 ◽

Vol 13 (2) ◽

pp. 204-216 ◽

Cited By ~ 61

Author(s):

Xiaomei Cong ◽

Susan M. Ludington-Hoe ◽

Stephen Walsh

Keyword(s):

Data Collection ◽

Preterm Infants ◽

Salivary Cortisol ◽

Serum Cortisol ◽

Kangaroo Care ◽

Skin Contact ◽

Infant Pain ◽

Skin To Skin ◽

Incubator Care ◽

Pain Responses

Kangaroo care (KC), skin-to-skin contact between mother and infant, is a promising method for blunting pain responses. This crossover pilot tested KC effects on biobehavioral responses to heel stick in preterm infants (30—32 weeks’ gestational age, 2—9 days old) measured by Premature Infant Pain Profile (PIPP) and salivary and serum cortisol. Mother—infant dyads were randomly assigned to KC heel stick (KCH) first or incubator heel stick (IH) first. Study 1 (80-min study, N = 18) tested the effect of 80 min of KC before and throughout the heel stick procedure versus incubator care. Study 2 (30-min study, N = 10) tested 30 min of KC before and throughout the heel stick versus incubator care. KCH and IH began during a premeasurement phase and continued through four data collection phases: baseline, heel warming, heel stick, and recovery. PIPP responses were measured every 30 s during data collection; salivary cortisol was measured at the end of baseline and recovery; and serum cortisol was measured during heel stick. Study 1 showed no differences between KCH and IH. Study 2 showed lower PIPP scores at four time points during recovery (p < .05 to p < .001), lower salivary cortisol at the end of recovery (p < .05), and lower serum cortisol during heel stick for the KCH condition (p < .05) as well as clinically lower PIPP scores in the KCH condition during heel stick. Thirty minutes of KC before and throughout the heel stick reduced biobehavioral responses to pain in preterm infants.

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A Clinical Comparison of Radiant Warmer and Incubator Care for Preterm Infants From Birth to 1800 Grams

PEDIATRICS ◽

10.1542/peds.108.2.395 ◽

2001 ◽

Vol 108 (2) ◽

pp. 395-401 ◽

Cited By ~ 40

Author(s):

M. P. Meyer ◽

M. J. Payton ◽

A. Salmon ◽

C. Hutchinson ◽

A. de Klerk

Keyword(s):

Preterm Infants ◽

Clinical Comparison ◽

Radiant Warmer ◽

Incubator Care

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Kangaroo care versus incubator care in the management of well preterm infants—a pilot study

Annals of Tropical Paediatrics ◽

10.1080/02724936.1998.11747932 ◽

1998 ◽

Vol 18 (2) ◽

pp. 81-86 ◽

Cited By ~ 29

Author(s):

R. A. Kambarami ◽

O. Chidede ◽

D. T. Kowo

Keyword(s):

Pilot Study ◽

Preterm Infants ◽

Kangaroo Care ◽

Incubator Care

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Cot-nursing versus incubator care for preterm infants

10.1002/14651858.cd003062 ◽

2001 ◽

Cited By ~ 4

Author(s):

Peter H Gray ◽

Vicki Flenady

Keyword(s):

Preterm Infants ◽

Incubator Care

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Cerebral oxygenation during skin-to-skin care in preterm infants not receiving respiratory support

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2016-312471 ◽

2017 ◽

Vol 103 (2) ◽

pp. F137-F142 ◽

Cited By ~ 4

Author(s):

Laila Lorenz ◽

Adriana Marulli ◽

Jennifer A Dawson ◽

Louise S Owen ◽

Brett J Manley ◽

...

Keyword(s):

Preterm Infants ◽

Near Infrared ◽

Cerebral Oxygenation ◽

Skin Care ◽

Mean Difference ◽

Respiratory Support ◽

Cerebral Hypoxia ◽

Quiet Sleep ◽

Skin To Skin ◽

Incubator Care

ObjectiveSkin-to-skin care (SSC) has proven benefits in preterm infants, but increased hypoxic and bradycardic events have been reported. This may make clinicians hesitant to recommend SSC as standard care. We hypothesised that regional cerebral oxygenation (rStO2) measured with near infrared spectroscopy is not worse during SSC compared with standard incubator care.DesignProspective, observational, non-inferiority study.SettingSingle tertiary perinatal centre in Australia.PatientsForty preterm infants (median (IQR) 30.6 (29.1–31.7) weeks' gestation) not receiving respiratory support were studied on day 14 (8–38).InterventionsRecordings during 90 min of incubator care, followed by 90 min of SSC. Each infant acted as their own control and caregivers were blinded to the rStO2 measurements.Main outcome measuresThe primary outcome was the mean difference in rStO2 between SSC and incubator care. The prespecified margin of non-inferiority was −1.5%. Secondary outcomes included heart rate (HR), peripheral oxygen saturation (SpO2), time in quiet sleep, temperature and hypoxic (SpO2 <80% for >5 s) or bradycardic events (HR <80 bpm for >5 s) and time spent in cerebral hypoxia (rStO2<55%) and hyperoxia (rStO2>85%).ResultsMean (SD) rStO2 was lower during SSC compared with incubator care: 73.6 (6.0)% vs 74.8 (4.6)%, mean difference (95% CI) 1.3 (2.2 to 0.4)%. HR was 5 bpm higher, SpO2 1% lower and time in quiet sleep 24% longer during SSC. Little evidence of a difference was observed in temperature. The number of hypoxic or bradycardic events as well as the proportion of time spent in cerebral hypoxia and hyperoxia was very low in both periods.ConclusionsMean rStO2 was marginally lower during SSC without observed differences in hypoxic or bardycardic events but an increase in time spent in quiet sleep.Trial registration numberThis trial is linked to Australian New Zealand Clinical Trials Registry: identifier 12616000240448. It was registered pre-results.

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