title: Skin-to-skin care in preterm infants receiving respiratory support does not lead to physiological instability.
abstract: OBJECTIVE
  Providing skin-to-skin care (SSC) to preterm infants is standard practice in many neonatal intensive care units. There are conflicting reports on the stability of oxygen saturation (SpO2) during SSC, which may create a barrier to a wider implementation of SSC to infants receiving respiratory support. Regional cerebral oxygenation (rcO2) measured using near-infrared spectroscopy can serve as a surrogate parameter for cerebral oxygen delivery and consumption. We hypothesised that rcO2during SSC would be similar to standard care in preterm infants receiving respiratory support.
  
  
  METHODS
  Prospective observational non-inferiority study.
  
  
  METHODS
  Single tertiary perinatal centre in Australia.
  
  
  METHODS
  Forty preterm infants (median (IQR) of 27.6 (26.0-28.9) weeks' gestation) receiving respiratory support were studied on day 8 (5-18).
  
  
  METHODS
  Ninety minutes of SSC, with infants in incubators acting as their own control. Parents and caregivers were blinded to the measurements.
  
  
  METHODS
  Mean difference in rcO2between SSC and incubator care; as well as heart rate (HR), SpO2, fraction of inspired oxygen (FiO2) and temperature, were compared using a paired t-test.
  
  
  RESULTS
  rcO2was similar during SSC (mean (SD) 74.9 (6.5)%)% compared with incubator care (74.7 (6.1)%, mean difference (95% CI) 0.2 (-0.8 to 1.1)%, p=0.71). No clinically important differences in HR, SpO2, FiO2or temperature were observed in the whole cohort and by mode of respiratory support (endotracheal tube mechanical ventilation, continuous positive airway pressure and high-flow nasal cannulae).
  
  
  CONCLUSIONS
  Cerebral oxygenation and other physiological measurements in ventilated preterm infants did not differ between SSC and incubator care.
  
  
  BACKGROUND
  12615000959572.
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Department of Neonatology, University Children's Hospital Tübingen, Tübingen, Germany.
authors.forename: Laila
authors.initials: L
authors.lastname: Lorenz
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dawson
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Jones
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Jacobs
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: Jeanie L
authors.initials: JL
authors.lastname: Cheong
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Donath
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
authors.affiliation: Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.|University of Melbourne, Melbourne, Australia.
authors.forename: C Omar F
authors.initials: COF
authors.lastname: Kamlin
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D001315:Australia; D045422:Continuous Positive Airway Pressure / Q000379:methods; D003422:Critical Care / Q000379:methods; D007235:Infant, Premature, Diseases / Q000628:therapy; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000379:methods; D060127:Kangaroo-Mother Care Method / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D019124:Therapeutic Touch / Q000379:methods
keywords: Intensive Care; Neonatology; Neurology; Physiology