ABSTRACT
Background@#Transporting preterm neonates soon after birth entails risks. Only one study among many about the beneficial effects of Kangaroo Mother Care (KMC) had cited it as a safe and effective alternative to transport incubators. @*Objective@#To determine if KMC transport could be an alternative to transport incubators by comparing the physiological outcomes of the two transport methods. @*Methods@#This is a parallel non-blinded randomized-controlled trial funded by KMC Foundation, Philippines, Inc, of physiologically stable preterm neonates weighing ≤ 2200 grams delivered at a tertiary government hospital from September 10, 2011, to April 18, 2012. After obtaining written consent from their mothers, participants were randomly assigned to either the intervention or control group. The intervention groups were transported from the delivery room to the NICU while on skin-to-skin contact with the caregiver. In contrast, those in the control group were placed in a transport incubator. Vital signs, oxygen saturation, and blood glucose were measured before transport and upon NICU arrival. Adverse effects were monitored. Data were recorded using a standard database. @*Results@#Ninety-two participants were recruited, forty-six in each arm. Two dropped out. The mean change in heart rate in the KMC transport decreased by 1.6 beats per minute; respiratory rate decreased by 0.18 breaths per minute, the temperature increased by 0.01°C, oxygen saturation decreased by 0.07%, blood glucose decreased by 5.07 mg/dL. The measured physiological parameters were not statistically significant between the two groups. In the KMC transport, there was a decreasing trend in the incidence of hypothermia, hypoglycemia, tachypnea, and tachycardia. @*Conclusion@#There are no significant differences in the heart rate, respiratory rate, temperature, oxygen saturation, and blood glucose levels among preterm neonates on KMC transport compared with preterm neonates on transport incubators, which is the current standard of care. The study showed that KMC transport is equally effective as a transport incubator. Hence, in low-resource settings, KMC transport may be used as a safe and effective neonatal transport.
Subject(s)
Kangaroo-Mother Care Method , IncubatorsABSTRACT
Abstract@#Sepsis is a common cause of morbidity and mortality among high risk neonates with intrauterine maternal history of infection. Objectives: The main objective of this study is to describe all potentially septic newborns in the neonatal care unit of the Baguio General Hospital and Medical Center (BGH) including identification of the maternal risk factors and clinico-bacteriologic profile of sepsis of this study population. @*Methods@#This is a retrospective, descriptive study where medical records of all admitted potentially septic neonates from July 1, 2004 to June 30, 2006 were reviewed. Neonates who were preterm, asphyxiated, with congenital anomalies and with incomplete charts were excluded. Data such as demographics, maternal risk factors, and clinical course were recorded using a standardized clinical assessment form. @*Results@#Out of 217 subjects, 74% (204) were included in the study. 53% were males, with birth weights of 2500 to (-) 3800 grams (85.29%) and delivered via normal, spontaneous delivery (63.24%). The more common maternal risk factor identified included premature rupture of membranes (77%), non-institutional delivery (9.2%), and maternal urinary tract infection (4.2%). 85.78% of subjects had culture negative results, while 14.22% had culture positive results . Among patients with culture negative results, 22.29% developed clinical signs of sepsis such as poor suck, pneumonia, fever, shock, and thrombocytopenia. In patients with culture positive results, the most common organisms isolated were Enterobacter aerogenes (55%), Acinetobacter baumanii (14%) and Coagulase negative staphylococcus (14%). Among these patients, 10 % presented with meningitis, pneumonia, and poor suck. Empiric antibiotics used at the time of study were Penicillin G and an aminoglycoside. 66% of the asymptomatic patients with culture negative results had 3 days duration of treatment. 94.6% went home improved. @*Conclusion@#Pediatricians should have a high index of suspicion for the possibility of sepsis guided by complete perinatal history, thorough physical examination, and laboratory work-up. Even with negative blood culture results, neonates with maternal risk factors can develop signs and symptoms of sepsis; and with the emergence of new pathogens that may cause early neonatal sepsis, it is prudent to do blood culture and sensitivity and start empiric antibiotics.