Physiologic Stability of Intubated VLBW Infants During Skin-to-Skin Care and Incubator Care

PURPOSE Skin-to-skin care (SSC), also known as “kangaroo care,” has been adopted for the intubated very low birth weight (I-VLBW) infant based on data from a healthier population of infants requiring little or no supplemental oxygen. The purpose of this study was to test the effect of SSC on physiologic responses in I-VLBW infants. Specific variables of interest include central/peripheral temperature difference, fraction of inspired oxygen (FIO2), and oxygen saturation. SUBJECTS Fourteen I-VLBW infants participated in the study and completed the protocol. DESIGN/METHODS An experimental, interrupted time series crossover design was used with infants randomly assigned to treatment order, intermittent SSC (treatment) versus incubator care (control). Data collection was facilitated by a computer data acquisition system. Data were analyzed by using repeated measures multivariate analysis of variance. RESULTS Infants weighed 990 ± 155 g and had a corrected gestational age of 30 ± 1 weeks. Mean central/peripheral temperature difference decreased from a baseline of 0.86°C (±0.4°) to 0.36°C (± 0.3°) during the first hour of SSC (P = .002) and to 0.12°C (± 0.3°) during the second hour of SSC (P = .01). Mean FIO2 increased during SSC (mean FIO2 = 45% = 8.6%) compared with incubator care (mean FIO2 = 36% ± 8.8%) (P = .009). Oxygen saturation was lower during SSC, but this finding was not statistically significant. CONCLUSIONS Intubated VLBW infants did not show stability of these physiologic variables during SSC and were more stable during the incubator phase (control). Data demonstrating physiologic stability during SSC are necessary before SSC are routinely adopted for the I-VLBW infant.