Kangaroo Care Compared to Incubators in Maintaining Body Warmth in Preterm Infants

Ludington‐Hoe, Susan M.; Nguyen, Nhuha; Swinth, Joan Y.; Satyshur, Rosemarie DiMauro

doi:10.1177/109980040000200107

Cited by 98 publications

(80 citation statements)

References 70 publications

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“…Various interventions for prevention and management of hypothermia have been tested in community as well as hospital settings, and have added to the existing evidence base. 3,5,8,[89][90][91][92][93][94] Warm chain The 'warm chain' 32 is a set of 10 interlinked procedures to be taken at birth and during the following few hours and days to prevent hypothermia by minimizing heat loss in all newborns. Failure to implement any one of these procedures will break the chain and put the newborn baby at risk of hypothermia.…”

Section: Recognition Of Hypothermia Measurement and Detectionmentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Recognition Of Hypothermia Measurement and Detectionmentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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“…This search retrieved four kangaroo care studies. [38][39][40][41] One trial was presented at the 2005 meeting of the American Pediatric Society and was included in abstract form, which has not been published in full. 42 Of the 72 articles retrieved, only 25 trials reported our primary outcome of interest and were included in this review.…”

Section: Identification Of Relevant Studiesmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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Objective: To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older.Study Design: Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported.Result: Identified studies (n ¼ 25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N ¼ 2198 infants) found significantly higher mental (N ¼ 2198) and physical (N ¼ 1319) performance scores favoring the intervention group. At 24 months, the mental (N ¼ 1490) performance scores were improved, but physical (N ¼ 1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N ¼ 961) and 5 years (N ¼ 1017). Conclusion:Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

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“…Period 4 (cycle duration 20 to 29 min) could be vasogenic in origin or could be a result of inherent engineering properties of the servomechanism of the incubator. 25,[29][30][31][32] The cycling period at which peak coherence was observed in this study had a median of 2 h, much longer than the typical cycling time of current servo-controlled incubators adjusting output to patient's temperature, that is, around 20 min. 25 Vasogenic changes could be assessed by following the abdomen-to-toe skin temperature gradient, which is known to decrease with Kangaroo care.…”

Section: Discussionmentioning

confidence: 99%

“…25 Vasogenic changes could be assessed by following the abdomen-to-toe skin temperature gradient, which is known to decrease with Kangaroo care. 32 Fourth, artifactual data resulting from handling or loose probes posed additional problems in the two patients who were eliminated from the study. Fifth, it is possible that in our study the skinenvironmental gradient was increased 33 and that temperature cycles were attenuated in our study because of shielding the thermistor probes.…”

Section: Discussionmentioning

confidence: 99%

Frequency analysis of air and skin temperature in neonates in servo-controlled incubators

et al. 2006

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Objective: To test a new system designed for digital recording of skin and air temperature, thereby allowing analysis of cyclic changes in temperature in neonates in servo-controlled incubators.Methods: Analysis of cyclic changes of serial skin and air temperature in asymptomatic infants in servo-controlled incubators adjusting heat output to the patient's temperature.Results: In nine asymptomatic neonates ranging from 25 to 40 weeks of gestational age, analysis showed peaks of coherence (squared correlation) between skin and air temperature measurements at periods ranging between 1.5 and 3 h. Conclusion:We have established a new system to study cyclic changes in skin and air temperature in neonates in servo-controlled incubators. The analysis of this pilot study suggests that the most important changes in skin and air temperature in asymptomatic neonates occur at a periodicity of 1.5 to 3 h, which is similar to that previously described for neonatal temperature. Additional data are required to determine whether this new system may be useful in neonatal care.

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Kangaroo Care Compared to Incubators in Maintaining Body Warmth in Preterm Infants

Cited by 98 publications

References 70 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

Frequency analysis of air and skin temperature in neonates in servo-controlled incubators

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