Effects of Kangaroo Mother Care on Repeated Procedural Pain and Cerebral Oxygenation in Preterm Infants

2021 ◽  
Author(s):  
Yu Wang ◽  
Linping Zhang ◽  
Wenbin Dong ◽  
Rong Zhang
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Cerebral Oxygenation ◽  
Intervention Group ◽  
Recovery Phase ◽  
Kangaroo Mother Care ◽  
Procedural Pain ◽  
Control Group ◽  
Blood Collection ◽  
Infant Pain

Objective The study aimed to investigate the effects of kangaroo mother care (KMC) on repeated procedural pain and cerebral oxygenation in preterm infants. Study Design Preterm infants of 31 to 33 weeks of gestational age were randomly divided into an intervention group (n = 36) and a control group (n = 37). Premature infant pain profile (PIPP) scores, heart rate, oxygen saturation, regional cerebral tissue oxygenation saturation (rcSO2), and cerebral fractional tissue oxygen extraction (cFTOE) were evaluated during repeated heel stick procedures. Each heel stick procedure included three phases: baseline, blood collection, and recovery. KMC was given to the intervention group 30 minutes before baseline until the end of the recovery phase. Results Compared with the control group, the intervention group showed lower PIPP scores and heart rates, higher oxygen saturation, and rcSO2 from the blood collection to recovery phases during repeated heel sticks. Moreover, there were significant changes in cFTOE for the control group, but not the intervention group associated with repeated heel stick procedures. Conclusion The analgesic effect of KMC is sustained over repeated painful procedures in preterm infants, and it is conducive to stabilizing cerebral oxygenation, which may protect the development of brain function. Key Points

scholarly journals Effectiveness of Reverse Kangaroo Mother Care Position in Decreasing Adverse Physiological Events and Pain during Screening of Premature Infants for Retinopathy of Prematurity

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Ma. Socorro Fatima P. Calitis ◽  
Maria Esterlita T. Villanueva-Uy ◽  
Socorro De Leon-Mendoza ◽  
Maria Angelica Villano ◽  
Jazel Eleazer-Verde
Keyword(s):  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Position Control ◽  
Low Cost ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Control Group ◽  
Infant Pain ◽  
Pipp Score ◽  
Rop Screening

Background. Retinopathy of prematurity (ROP) screening is uncomfortable and even painful in preterm infants. Objective. To determine the effectiveness of the Reverse-Kangaroo Mother Care (R-KMC) position compared with the conventional position in decreasing adverse physiological events and pain during ROP screening. Methods. This was a parallel randomized controlled trial with two arms- R-KMC position and conventional position (control). The primary outcomes included increased oxygen saturation, decreased heart and respiratory rates, and decreased pain intensity measured by Prematurity Infant Pain Profile (PIPP). Results. There were 100 preterm infants recruited. There were no differences in baseline characteristics, mean ROP screening duration, mean physiological parameters after the mydriatic application and during ROP screening between the two. Only the mean respiratory rates were significantly lower among the R-KMC group during the application of mydriatric agent. (50.26 ± 6.18 vs. 51.6 ± 8.35; p=0.0191). Relative risk (RR) in the control group is 37 to 84 versus 40 to 68 in the R-KMC group. The R-KMC group had a significantly lower mean PIPP score (6.5±2.06 vs. 8.8±2.80; p<0.0001) after mydriatic application and during ROP screening (7.6±2.05 vs. 9.8±2.90; p<0.0001) compared with control. No apnea was observed after mydriatic application, but one apneic episode was in control during ROP screening. 26% of the ROP screeners recommended the R-KMC position during ROP screening, while a majority (70%) was neutral. Conclusion. R-KMC position, a low-cost intervention, significantly reduces pain during ROP screening. It is recommended as a position of choice during ROP screening.

scholarly journals Pilot Testing a Robot for Reducing Pain in Hospitalized Preterm Infants

2019 ◽  
Vol 39 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Nicholas Williams ◽  
Karon MacLean ◽  
Ling Guan ◽  
Jean Paul Collet ◽  
Liisa Holsti
Keyword(s):  
Heart Rate ◽  
Preterm Infants ◽  
Standard Care ◽  
Pilot Trial ◽  
Low Frequency ◽  
Procedural Pain ◽  
Blood Collection ◽  
Randomized Controlled ◽  
Infant Pain

Optimizing neurodevelopment is a key goal of neonatal occupational therapy. In preterm infants, repeated procedural pain is associated with adverse effects on neurodevelopment long term. Calmer is a robot designed to reduce infant pain. The objective of this study was to examine the effects of Calmer on heart rate variability (HRV) during routine blood collection in preterm infants. In a randomized controlled pilot trial, 10 infants were assigned to either standard care ( n = 5, facilitated tucking [FT]) or Calmer treatment ( n = 5). HRV was recorded continuously and quantified using the area (power) of the spectrum in high and low frequency (HF: 0.15-0.40Hz/ms2; LF: 0.04-0.15 Hz/ms2) regions. Changes in HRV during three, 2-min phases (Baseline, Heel Poke, and Recovery) were compared between groups. Calmer infants had 90% greater parasympathetic activation ([PS] reduced stress) during Baseline, 82% greater PS activation during Poke, and 24% greater PS activation during Recovery than FT infants. Calmer reduced physiological preterm infant pain reactivity during blood collection.

ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

2020 ◽  
Author(s):  
Janet Elizabeth Berrington ◽  
William McGuire ◽  
NIcholas David Embleton
Keyword(s):  
United Kingdom ◽  
Preterm Infants ◽  
Late Onset ◽  
Disease Onset ◽  
Intervention Group ◽  
Control Group ◽  
Bovine Lactoferrin ◽  
The United Kingdom ◽  
Late Onset Sepsis ◽  
The Uk

Previous studies suggested that supplemental bovine lactoferrin (BLF) given to preterm infants (<32 weeks gestation) may reduce late onset sepsis (LOS) and necrotising enterocolitis (NEC), but have been underpowered. The Enteral Lactoferrin in Neonates (ELFIN) study, performed in the United Kingdom (UK), aimed to further address this issue with a well powered double blinded placebo controlled trial of >2200 preterm infants. ELFIN did not demonstrate a reduction in LOS or NEC, or several other clinically important measures. 316 (29%) of 1093 infants in the intervention group developed late-onset sepsis versus 334 (31%) of 1089 in the control group with an adjusted risk ratio of 0·95 (95% CI 0·86–1·04; p=0· 233). Reasons for the differences in ELFIN trial results and other studies may include population differences, the routine use of antifungals in the UK, timing of administration of the lactoferrin in relation to disease onset, or specific properties of the lactoferrin used in different trials. Further exploration is being undertaken in the UK NIHR funded Mechanisms Affecting the Guts of Preterm Infants in Enteral feeding trials (MAGPIE) study, for which results should be available soon.

scholarly journals Effect of Semi-Recumbent Position on Blood Oxygen Saturation in Postanesthetic Patients After Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 82-85
Author(s):  
Xiaoling Chen ◽  
Yuelan Qin ◽  
Fanghua Gong
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Lung Function ◽  
Oxygen Saturation ◽  
Intervention Group ◽  
Control Group ◽  
Blood Oxygen ◽  
Recumbent Position ◽  
Blood Oxygen Saturation ◽  
Bed Elevation ◽  
Before And After

BackgroundUndergoing general anesthesia and pneumoperitoneum could affect the lung function and comprise oxygenation in laparoscopic cholecystectomy patients. Position of patients after surgery may affect lung function of these patients.AimTo observe the effect of semi-recumbent position on blood oxygen saturation (SpO2) in postanesthetic patients after laparoscopic cholecystectomy.MethodsA number of 225 patients who admitted to postanesthetic care unit after laparoscopic cholecystectomy from September 2016 to May 2017 were randomly assigned into the intervention group and the control group. The intervention group adopted a semi-recumbent position with head bed elevation by 10 to 20°, while the control received a supine position without lying on a pillow. Both groups received routine postanesthesia care. Data on SpO2 before and after extubation were collected. Independent t-test was used for data analysis.ResultsThere was no vomiting and cough reactions before and after extubation in both groups. Intervention group reported a significantly higher level of SpO2 at 1 minute and 30 minutes after extubation, compared to the control group (both ps < 0.05).ConclusionSemi-recumbent position with the head bed elevation could significantly increase the SpO2 level of postanesthetic patients, thus ensuring the safety of patients when removing the endotracheal tube.

scholarly journals Serial Assessment of Body Fat and Fat-Free Mass Accretion in Very Preterm Infants: A Randomized Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1067-1067
Author(s):  
Ariel Salas ◽  
Maggie Jerome ◽  
Paula Chandler-Laney ◽  
Namasivayam Ambalavanan
Keyword(s):  
Body Composition ◽  
Preterm Infants ◽  
Body Fat ◽  
Intervention Group ◽  
Feeding Practices ◽  
Control Group ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Study Participants ◽  
Serial Assessments

Abstract Objectives To incorporate assessment of body composition in the routine care of preterm infants to guide feeding practices before and after hospital discharge. Methods Very preterm infants with gestational ages between 29 and 32 weeks of gestation were included. Infants with gastrointestinal or neurologic malformations and terminal illness needing to limit or withhold support were excluded. All study participants were eligible for serial assessments of body composition between birth and 32 weeks PMA, at 36 weeks PMA or hospital discharge, and at 3 months of corrected age. Infants randomly assigned to the intervention group had the information about infant body composition available to the clinicians caring for them (including reference data). Infants randomly assigned to the control group also underwent serial assessments, but this information on infant body composition was not shown to the clinicians caring for them. The primary outcome was % body fat (%BF) estimated by air displacement plethysmography. Results Fifty very preterm infants were randomized. Mean birthweight of study participants was 1387 g +/– SD 283 and median gestational age at birth was 30 weeks (IQR: 30 – 31). Sociodemographic characteristics did not differ between groups. Mean %BF between birth and 32 weeks PMA (n = 45) was 6 +/– 4, mean %BF at 36 weeks PMA (n = 35) was 14 +/– 4, and mean %BF at 3 months of corrected age (n = 25) was 20 +/– 4. Mean differences in %BF between the intervention group and the control group were not statistically significant at 36 weeks PMA (−0.8) or 3 months corrected age (−1.2). Similarly, feeding practices during hospitalization did not differ between groups. Growth outcomes did not differ between groups. Conclusions Serial assessments of body composition at birth, 36 weeks PMA, and 3 months corrected age in very preterm infants show increased %BF in both intervention and control groups without an apparent influence of the intervention on feeding practices. While 36 weeks PMA has been a common assessment point for research purposes, body composition assessments may need to be done at earlier intervals in order to make meaningful clinical changes to the infant diet in order to affect body composition later in infancy. Funding Sources UAB OHDRC.

scholarly journals Impact of regular chest percussion on outcome measures for infants with pneumonia

2019 ◽  
Vol 10 (4) ◽  
pp. 11
Author(s):  
Eman Abdel Fattah Hassan ◽  
Hoda Wahid Amer
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Outcome Measures ◽  
Respiratory Health ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Significance Level ◽  
Quasi Experimental ◽  
The Impact

Objective: To evaluate the impact of regular chest percussion on outcome measures for infants with pneumonia.Methods: A two-group pre-post quasi-experimental design was conducted in the Pediatrics Medical Unit at Abu Elrish Children’s Hospital, Cairo University. The experiment involved 100 infants fifty (control group) followed the hospital routine care and other fifty applied regular chest percussion (intervention group). Chest condition was assessed subjectively and objectively throughout five days before and after the regular chest percussion using Pediatrics Respiratory Severity Scales. Physiological measurements of infant’s respiratory rate, heart rate, and temperature and oxygen saturation were assessed. All research ethics were applied.Results: The mean of Pediatric Respiratory Severity Score (PRSS), temperature, respiration, heart rate and oxygen saturation among infants was statistically improved throughout the intervention days than the control group 1st, 2nd, 3rd and 4th days post the regular chest percussion at a significance level as p < .05.Conclusions: The regular chest percussion had a significant improvement in the respiratory health conditions for infants with bacterial pneumonia. This study recommends regular chest percussion that should be applied in medicine and intensive care units. Further researches must be done to add more evidence -based practices regarding the effect of chest percussion for children with pneumonia.

scholarly journals Effect of early versus standard central line removal on growth of very low birthweight premature infants: a protocol for a non-inferiority randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030167
Author(s):  
Justyna Romańska ◽  
Wojciech Margas ◽  
Renata Bokiniec ◽  
Paweł Krajewski ◽  
Joanna Seliga-Siwecka
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Low Birthweight ◽  
Intervention Group ◽  
Central Line ◽  
Optimal Time ◽  
Control Group ◽  
Very Low Birthweight ◽  
Central Lines ◽  
The Mean

IntroductionUncertainty exists regarding the optimal time for removal of central lines used to provide parenteral nutrition in preterm infants. The aim of this study is to determine whether earlier central line removal is non-inferior to its removal after reaching full enteral intake, in respect to growth outcome of preterm infants.Methods and analysisVery low birthweight premature infants will be recruited. Eligible infants will be randomised in equal proportions between two groups. In the intervention group central lines will be removed when infants reach 100 mL/kg/day of enteral intake. In the control group central lines will be removed when infants reach 140 mL/kg/day of enteral intake (full enteral intake). The primary outcome measure will be the difference between the two groups in weight at 36 weeks’ postmenstrual age. Non-inferiority will be declared if the mean weight of children in the intervention group will be no worse than the mean weight of children from the control group, by a margin of −210 g.Ethics and disseminationThe Bioethics Committee of the Medical University of Warsaw approved the study protocol prior to recruitment. The findings of this trial will be submitted to a peer-reviewed journal (neonatology, paediatrics or nutrition). Abstracts will be submitted to relevant national and international conferences.Trial registration numberNCT03730883.Protocol versionVersion 3. 14.08.2019.

scholarly journals Tactile-kinesthetic stimulation to gain weight and reduce the length of stay care for premature baby at public hospitals of Semarang, Indonesia

2019 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Freya Nazera Iskandar ◽  
Ari Suwondo ◽  
Bedjo Santoso
Keyword(s):  
Birth Weight ◽  
Length Of Stay ◽  
Low Birth Weight ◽  
Intervention Group ◽  
Premature Baby ◽  
Kangaroo Mother Care ◽  
Public Hospitals ◽  
Control Group ◽  
Hospital Unit ◽  
Premature Babies

Background: Premature babies are susceptible to a variety of health problems in early of their lives, thus, management of premature care should be designed to optimize the growth and development, with no more cost extension. The management of premature care by non-pharmacological treatments becomes popular nowadays, and applied in the hospital unit care, including the Tactile-Kinesthetic Stimulation (TKS) and Kangaroo Mother Care (KMC).Aims: This study is to present the effect of Tactile-Kinesthetic Stimulation (TKS) on weight gain and reduction length of stay care for premature babies, and to compare the results with the standard Kangaroo Mother Care (KMC) given at the hospital care unit.Methods: The study used a quasi-experimental design with pretest-posttest with a control group. A total of 32 premature babies was equally divided to a control group given a standard KMC procedure and an intervention group receiving the TKS. Sampling was done using a consecutive sampling method where the low birth weight infants were selected from two public hospitals in Semarang of Indonesia, with consent from the parents. Data was then analyzed by a repeated measure ANOVA, general linear model and Mann-Whitney test to find the significant mean difference at p value less than 0.05.Results: The data shows that the babies’ weight significantly increased day by day only if the premature neonates received Tactile-Kinesthetic Stimulation, gained 148.75 gram only 3 days after the initial measurement. However, from this study we noted that the premature babies’ weight at the control group provided only with Kangaroo Mother Care slightly decreased at 35.69 gram at the third day of observation. In average, premature babies receiving TKS need only 3 days before return home, while if receiving the standard KMC the preterm babies required 5 days in the hospital care.Conclusion: Not only effective to gain the weight, giving Tactile-Kinesthetic Stimulation to the low birth weight baby shorter the length of stay in the hospital unit care. It suggests that the TKS intervention will provide good result in maintaining the weight of the low birth weight baby and will reduce the costs of staying in the hospital unit care. Keywords: Tactile-Kinesthetic Stimulation, Kangaroo Mother Care, Low birth weight, Length of stay care, Premature baby.

scholarly journals Oxidative Stress Biomarker Decreased in Preterm Neonates Treated With Kangaroo Mother Care

2020 ◽  
Vol 22 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Dorothy Forde ◽  
Douglas D. Deming ◽  
John C. Tan ◽  
Raylene M. Phillips ◽  
Eileen K. Fry-Bowers ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Maternal Separation ◽  
Intervention Group ◽  
Kangaroo Mother Care ◽  
Energy Utilization ◽  
Infrared Spectrometry ◽  
Control Group ◽  
Increased Risk ◽  
The Impact ◽  
Incubator Care

Objective: Due to physiological and metabolic immaturity, prematurely born infants are at increased risk because of maternal separation in many neonatal intensive care units (NICUs). The stress induced from maternal–infant separation can lead to well-documented short-term physiologic instability and potentially lifelong neurological, sociological, or psychological sequelae. Based on previous studies of kangaroo mother care (KMC) that demonstrated improvement in physiologic parameters, we examined the impact of KMC on physiologic measures of stress (abdominal temperature, heart rate, oxygen saturation, perfusion index, near-infrared spectrometry), oxidative stress, and energy utilization/conservation in preterm infants. Methods: In this randomized, stratified study of premature neonates, we compared the effects on urinary concentrations of biomarkers of energy utilization and oxidative stress of 1 hr of KMC versus incubator care on Day 3 of life in intervention-group babies ( n = 26) and control-group babies ( n = 25), respectively. On Day 4, both groups received 1 hr of KMC. Urinary samples were collected 3 hr before and 3 hr after intervention/incubator care on both days. Energy utilization was assessed by measures of adenosine triphosphate (ATP) degradation (i.e., hypoxanthine, xanthine, and uric acid). Oxidative stress was assessed using urinary allantoin. Mixed-models analysis was used to assess differences in purine/allantoin. Results: Mean allantoin levels over Days 3 and 4 were significantly lower in the KMC group than in the control group ( p = .026). Conclusions: Results provide preliminary evidence that KMC reduces neonatal oxidative stress processes and that urinary allantoin could serve as an effective noninvasive marker for future studies.

scholarly journals Effects of Lactobacillus reuteri DSM 17938 in preterm infants: a double-blinded randomized controlled study

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Xuewei Cui ◽  
Yongyan Shi ◽  
Siyang Gao ◽  
Xindong Xue ◽  
Jianhua Fu
Keyword(s):  
Adverse Effects ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Lactobacillus Reuteri ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Daily Weight Gain ◽  
Control Group ◽  
Early Feeding ◽  
Feeding Tolerance

Abstract Background Preterm infants have immature gastrointestinal tracts and poor immunity. In this study, the effects of Lactobacillus reuteri DSM 17938 first on early feeding tolerance, growth, and second on infection prevention in preterm infants were evaluated. Methods One hundred fourteen formula-fed preterm infants with a gestational age between 30 weeks and 37 weeks, and a birth weight between 1500 and 2000 g were enrolled; 57 in the intervention and 57 in the control group:the intervention group was given a dose of 1 × 108 colony-forming units (5 drops) of L. reuteri DSM 17938 once daily, beginning with the first feeding until discharge. The control group did not receive probiotics. Early feeding tolerance (as time to full enterla feeding and number of reflux), growth, incidences of sepsis, localized infection, NEC, and adverse effects were recorded for both groups. Results The number of Daily reflux episodes (times/d) was lower (2.18 ± 0.83 vs. 3.77 ± 0.66, P < 0.01) and time to full enteral feedings (120 mL/kg/d) (9.95 ± 2.46 d vs. 13.80 ± 3.47 d, P < 0.05) was shorter in the intervention group. Average daily weight gain (14.55 ± 3.07 g/d vs. 10.12 ± 2.80 g/d), head circumference increas e(0.0760 ± 0.0157 cm/d vs. 0.0681 ± 0.0108 cm/d), and body length increase (0.1878 ± 0.0151 cm/d vs. 0.1756 ± 0.0166 cm/d) of the intervention group were higher (P < 0.01). There were no significant differences in the incidences of sepsis (4.44% vs. 8.33%), localized infection (6.67% vs. 8.33%), or NEC (2.22% vs. 10.42%) between the 2 groups (P > 0.05). The number of daily defecations (times/d) in the intervention group was higher (3.08 ± 0.33 vs. 2.29 ± 0.20, P < 0.01) and the length of hospital stay was shorter than that in the control group (20.60 ± 5.36 d vs. 23.75 ± 8.57 d, P < 0.05). No adverse effects were noted among the infants receiving L. reuteri. Conclusion L. reuteri may be an useful tool in improving early feeding tolerance in preterm infants, promoting growth, increasing the frequency of defecation, and shortening the length of hospital stay. Trial registration ChiCTR, ChiCTR1900025590. Registered 1 February 2019- Retrospectively registered, http://www.chictr.org.cn/listbycreater.aspx.

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