<b><i>Introduction:</i></b> Kangaroo care (KC) is defined by the World Health Organization as a method of care consisting in putting premature infants or newborns in skin-to-skin contact with their parents. KC is an effective method of promoting health and well-being of infants and their families. Physiological stability during KC has been widely analyzed, however with controversial results. <b><i>Methods:</i></b> A systematic review was conducted. Electronic databases searched included MEDLINE, Embase, CINAHL, and Scopus. Two authors independently reviewed and extracted information using a data extraction form. The methodological quality of the observational studies was assessed using “STROBE” and the “Cochrane Collaboration tool” for randomized controlled trials. The physiological monitoring parameters included were heart rate (HR), arterial oxygen saturation (SpO<sub>2</sub>), regional cerebral oxygen saturation (rScO<sub>2</sub>), and fractional oxygen extraction (FtOE). <b><i>Results:</i></b> A total of 345 articles were identified. First, 302 articles were excluded by title and then 34 articles after full-text analysis. Finally, a total of 25 studies were included. Physiological parameters monitored (HR, SpO<sub>2</sub>, rScO<sub>2</sub>, and FtOE) showed no significant changes at different study periods: pre-KC, during KC, and post-KC. <b><i>Conclusions:</i></b> We conclude that stable preterm infants receiving or not respiratory support show no significant differences in HR, SpO<sub>2</sub>, FtOE during KC compared to routine incubator care. rScO<sub>2</sub> remains stable during KC with slight upward trend. Further studies with a higher level of methodological quality are needed to confirm these findings.
<b><i>Introduction:</i></b> 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. <b><i>Methods:</i></b> 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 (rScO<sub>2</sub>), peripheral oxygen saturation (SpO<sub>2</sub>), 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 SpO<sub>2</sub>, HR, rScO<sub>2</sub>, and FtOE were compared between studied periods employing the Wilcoxon rank-sum test and the Friedman test, respectively. <b><i>Results:</i></b> A total of forty-three KC sessions with their corresponding pre-KC and post-KC segments were analyzed. The distributions of the SpO<sub>2</sub>, HR, rScO<sub>2</sub>, 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 (<i>p</i> = 0.019). <b><i>Conclusion:</i></b> 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 SpO<sub>2</sub> were shown. This novel data analysis methodology could be expanded to other clinical situations.
Aim
To verify if the concentrations of caffeine in saliva are comparable to the serum concentrations in preterm infants treated with caffeine for apnoea of prematurity.
Methods
Prospective observational study. Eligible patients were newborn infants < 37 weeks of gestational age treated with oral or intravenous caffeine for apnoea of prematurity. Two paired samples of saliva-blood were collected per patient. Tube solid phase microextraction coupled on-line to capillary liquid chromatography with diode array detection were used for analysis.
Results
A total of 47 newborns with a median gestational age 28 [26–30] weeks and mean of 1.11 ± 0.4 kg of birth weight. Median postmenstrual age, when samples were collected, was 31 [29–33] weeks. Serum caffeine median levels of 19.30 µg/mL [1.9–53.90]and salivary caffeine median levels of 16.36 µg/mL [2.20–56.90] were obtained. There was a strong positive Pearson’s correlation between the two variables r = 0.83 (p < 0.001).
Conclusion
The measurement of caffeine salivary concentrations after intravenous or oral administration offers an alternative to serum caffeine monitoring in apnoea of prematurity.
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