Mother-Infant Interaction, Neonatal Respiratory Distress, Preterm Birth
Conditions
Brief summary
Immediate skin-to-skin contact (SSC) is already standard care for healthy term newborns, but its use for term or preterm newborns requiring admission to neonatal unit (NICU) with or without respiratory support is challenging. This study aimed to assess the safety and feasibility of SSC during the transfer of newborn infants, using a new purpose-built mobile shuttle care-station, called Tandem. A monocentric prospective observational study was conducted at the tertiary referral center of the Université libre de Bruxelles in Brussels, Belgium Infants born with a birth weight above 1500g were eligible. Following initial stabilization, infants were placed in SSC with one of their parents and transferred to the NICU using the Tandem.
Detailed description
Prior to delivery, the trained neonatal team prepares both the Tandem and a transport incubator as a backup. Delayed umbilical cord clamping will be performed for at least one minute unless prompt resuscitation required. Then, infants will be stabilized on a resuscitation table following European Resuscitation Council guidelines, with applying electrodes for continous monitoring of heart rate, saturation and temperature. After initial stabilization respiratory support will be continued if needed using the Tandem's gas supply. In cases when, antibiotics or continuous IV glucose infusion are necessary, peripheral venous catheters will be placed before departure. In case of respiratory support, nasogastric tube will be insterted. Infants will be then transferred to the NICU under the supervision of a pediatric nurse and/or pediatrician with the Tandem in skin-to-skin position with either the mother or the father. Whenever possible, SSC will be continued for at least 120 minutes before placing the infant in an incubator. Blood glucose measurement will take place at least once during the procedure.
Interventions
None listed
Sponsors
Erasme University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
s: * neonates with an estimated foetal weight above1500 grams * neonates requiring admission to the neonatal intensive care unit * neonates requiring or not non-invasive respiratory support * neonates with at least one parent who has a good understanding of the method of transfer
Exclusion criteria
* neonates presenting a malformation incompatible with this type of transfer * neonates with invasive ventilation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of Skin-to-skin transfer | 0-2 hours of life | Rate of discontinuation of the skin-to-skin was measured |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Safety of Skin-to-skin transfer - Oxygenisation | 0-2 hours of life | Saturation measured in % ( considered normal \>92 %) |
| Safety of Skin-to-skin transfer- Temperature | 0-2 hours of life | Temperature measured in Celsius ( considered normal range: 36.5-37.5 C) |
| Safety of Skin-to-skin transfer - Hemodynamic | 0-2 hours of life | Heart rate measured in bpm (considered normal range: 120-180 bpm ) |
| Parental and nursing satisfaction | 0-1 days of life | Parental and nursing satisfaction with skin-to-skin transfer via the Tandem from the delivery suite or the operating theater to the NICU were rated on a scale from 1 to 10 (10 being the most satisfied) |
| Breastfeeding at hospital discharge | 1 day (at discharge) | Exclusive breastfeeding rate at discharge |
| Safety of Skin-to-skin transfer - Blood glucose | 0-2 hours of life | Blood glucose level measured in mg/dL at least once during the first two hours of life (considered normal range: 30-100 mg/dL) |
Countries
Belgium
Outcome results
None listed