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Title: | Impact of Skin-to-Skin Parent-Infant Care on Preterm Circulatory Physiology. | Authors: | Nitzan I.;Jayawickreme N.;Menahem S. ;Sehgal A. | Monash Health Department(s): | Paediatric - Neonatal (Monash Newborn) Paediatric - Cardiology |
Institution: | (Sehgal, Nitzan, Jayawickreme) Monash Newborn, Monash Children's Hospital, Melbourne, Australia (Sehgal) Department of Pediatrics, Monash University, Melbourne, Australia (Menahem) Pediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, Australia | Issue Date: | 15-Aug-2020 | Copyright year: | 2020 | Publisher: | Mosby Inc. (E-mail: customerservice@mosby.com) | Place of publication: | United States | Publication information: | Journal of Pediatrics. 222 (pp 91-97.e2), 2020. Date of Publication: July 2020. | Journal: | Journal of Pediatrics | Abstract: | Objectives: To ascertain the impact of skin-to-skin care between parents and infants on cardiac function and cerebral blood flow in preterm infants. Study design: We undertook a prospective study of 40 self-ventilating preterm infants at a quaternary center and assessed cardiac performance and cerebral blood flow. Assessments were carried out two hours before skin-to-skin care and then 60 minutes after skin-to-skin care (with the infant still on parent and turned supine). Result(s): Infants were 30.5 +/- 0.6 weeks' gestational age and 1378 +/- 133 g birthweight. Axillary temperature noted a nonsignificant increase during skin-to-skin care from 36.7 +/- 0.07degreeC to 36.9 +/- 0.07degreeC (P =.07). Cardiac contractility (right ventricular fractional area change [26.5% +/- 0.3% vs 27.8% +/- 0.4; P <.001] and tricuspid annular plane systolic excursion [0.73 +/- 0.03 cm vs 0.77 +/- 0.03 cm; P =.02]) increased significantly, coincident with decreased measures of pulmonary vascular resistance. An increase in systemic cardiac output was associated with increased cerebral blood flow and reduced middle cerebral artery resistive index (0.81 +/- 0.02 vs 0.74 +/- 0.02; P =.0001). Conclusion(s): We documented a significant circulatory beneficial adaptation to a common neonatal practice. These findings align with previously documented physiologic benefits in cardiorespiratory stability and cardiac rhythm in preterm infants, and may be mediated through modulation of the autonomic nervous system.Copyright © 2020 Elsevier Inc. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.jpeds.2020.03.041 | PubMed URL: | 32389414 [http://www.ncbi.nlm.nih.gov/pubmed/?term=32389414] | ISSN: | 0022-3476 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/29176 | Type: | Article | Subjects: | heart right ventricle ejection fraction heart right ventricle function heart stroke volume human *infant care lung vascular resistance male middle cerebral artery newborn positive end expiratory pressure *prematurity priority journal prospective study resistive index tricuspid annular plane systolic excursion heart right ventricle fractional area time to peak velocity velocity time integral *kangaroo care article axilla temperature birth weight *brain blood flow cardiovascular parameters clinical article ductus arteriosus female fractional shortening gestational age *heart function heart muscle contractility heart output heart performance heart rate heart rhythm heart right ventricle ejection fraction heart right ventricle function heart stroke volume infant care lung vascular resistance middle cerebral artery newborn positive end expiratory pressure prematurity resistive index tricuspid annular plane systolic excursion heart right ventricle fractional area time to peak velocity velocity time integral kangaroo care axilla temperature birth weight brain blood flow cardiovascular parameters ductus arteriosus fractional shortening gestational age heart function heart muscle contractility heart output heart performance heart rate heart rhythm heart muscle contractility heart output heart performance heart rate heart rhythm heart right ventricle ejection fraction heart right ventricle function heart stroke volume human *infant care *kangaroo care lung vascular resistance male middle cerebral artery newborn positive end expiratory pressure *prematurity priority journal axilla temperature resistive index tricuspid annular plane systolic excursion Article prospective study birth weight *brain blood flow cardiovascular parameters clinical article ductus arteriosus female fractional shortening gestational age *heart function |
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