Effects of Kangaroo Care on the development of oral skills and achievement of exclusive oral feeding in preterm infants.

PURPOSE: analyze the effects of hospitalization in the Kangaroo Neonatal Intermediate Care Unit (UCINCa), the second stage of the Kangaroo Care (KC), on the development of oral feeding skills in preterm neonates. METHODS: an analytical observational study of the prospective longitudinal type, carried out in a public hospital in Southern Brazil, where infants were accompanied until hospital discharge. The sample consisted of 20 preterm neonates hospitalized at the UCINCa and 26 preterm neonates at the Conventional Neonatal Intermediate Care Unit (UCINCo), that were periodically evaluated through the levels of oral skill, in a bottle, according to the criteria of proficiency and milk transfer rate. The outcomes considered were a progression of the oral skill level, days of transition to obtain the full oral route, and days of hospital stay. RESULTS: the duration of transition to exclusive oral feeding was shorter for preterm neonates at the UCINCa (4.5 vs. 10 days) relative to those at the UCINCo (p = 0.041). By the third assessment, all preterm neonates at the UCINCa had reached level 4, while participants at the UCINCo only achieved this level of performance on the fifth assessment. The average number of days of hospitalization was four days shorter in UCINCa participants (p=0.098). CONCLUSION: the admission to the UCINCa had been a further acceleration in the maturation of oral skills, which allowed for a faster transition to exclusive oral feeding as compared to neonates admitted in UCINCo.

Effects of Kangaroo Care on the development of oral skills and achievement of exclusive oral feeding in preterm infants / Efeitos do Método Canguru no desenvolvimento das habilidades orais e na aquisição da alimentação oral exclusiva em recém-nascidos pré-termo

ABSTRACT Purpose analyze the effects of hospitalization in the Kangaroo Neonatal Intermediate Care Unit (UCINCa), the second stage of the Kangaroo Care (KC), on the development of oral feeding skills in preterm neonates. Methods an analytical observational study of the prospective longitudinal type, carried out in a public hospital in Southern Brazil, where infants were accompanied until hospital discharge. The sample consisted of 20 preterm neonates hospitalized at the UCINCa and 26 preterm neonates at the Conventional Neonatal Intermediate Care Unit (UCINCo), that were periodically evaluated through the levels of oral skill, in a bottle, according to the criteria of proficiency and milk transfer rate. The outcomes considered were a progression of the oral skill level, days of transition to obtain the full oral route, and days of hospital stay. Results the duration of transition to exclusive oral feeding was shorter for preterm neonates at the UCINCa (4.5 vs. 10 days) relative to those at the UCINCo (p = 0.041). By the third assessment, all preterm neonates at the UCINCa had reached level 4, while participants at the UCINCo only achieved this level of performance on the fifth assessment. The average number of days of hospitalization was four days shorter in UCINCa participants (p=0.098). Conclusion the admission to the UCINCa had been a further acceleration in the maturation of oral skills, which allowed for a faster transition to exclusive oral feeding as compared to neonates admitted in UCINCo.

RESUMO Objetivo verificar os efeitos da internação em Unidade de Cuidado Intermediário Neonatal Canguru (UCINCa), segunda etapa do Método Canguru, no desenvolvimento das habilidades de alimentação oral em recém nascidos pré-termo (RNPT). Método estudo observacional analítico do tipo longitudinal prospectivo, realizado em um hospital público no Sul do Brasil, com acompanhamento até a alta hospitalar. A amostra foi constituída por 20 RNPT internados na UCINCa e 26 RNPT na Unidade de Cuidado Intermediário Neonatal Convencional (UCINCo), que foram avaliados periodicamente por meio dos níveis de habilidade oral, em mamadeira, conforme os critérios de proficiência e taxa de transferência de leite. Os desfechos considerados foram progressão do nível de habilidade oral, dias de transição para obtenção da via oral plena, dias de internação hospitalar. Resultados o tempo de transição para obtenção da via oral exclusiva foi menor nos RNPT da UCINCa (4,5 dias versus 10 dias) quando comparados aos da UCINCo (p=0,041). Na terceira avaliação de habilidade oral, a totalidade de RNPT da UCINCa atingiu o nível 4, já os participantes da UCINCo somente alcançaram esse nível na quinta avaliação. A mediana dos dias de internação foi de quatro dias menor nos participantes da UCINCa (p=0,098). Conclusão a internação na UCINCa favoreceu uma aceleração no processo de maturação das habilidades orais, influenciando positivamente na transição alimentar oral do RNPT, na comparação com os RNPT internados na UCINCo.

Vancomycin and creatinine determination in dried blood spots: Analytical validation and clinical assessment.

This study aims to develop a liquid chromatography tandem-mass spectrometry (LC-MS/MS) method for vancomycin and creatinine measurement in dried blood spots (DBS) and to evaluate its clinical application. The analytes were extracted from DBS and analyzed by LC-MS/MS. Vancomycin and creatinine DBS and plasma concentrations were compared in 54 and 35 samples, respectively, from 29 patients. Accuracy was 94.4-102.6%, intra-assay precision was 2.1-5.6%, and inter-assay precision was 3.5-7.0%. Patients vancomycin plasma to DBS concentration ratios were highly variable (1.148-5.022), differently from creatinine (0.800-1.283). The assay has adequate analytical performance. Plasma concentrations can be satisfactorily predicted from DBS measurements for creatinine, but not for vancomycin, which limits its clinical application.