Monitoring lung and cerebral oxygenation using near-infrared spectroscopy in preterm infants during kangaroo mother care

Abstract

Lung function has never been assessed during kangaroo mother care (KMC) in preterm infants. We measured lung (rSO₂L) and cerebral (rSO₂C) oxygenation by near-infrared spectroscopy (NIRS) in infants born at less than 32 weeks of gestation or weighing ≤ 1500 g during KMC. rSO₂L, rSO₂C, and pulmonary (FOEL) and cerebral (FOEC) tissue oxygen extraction fraction were measured in 20 preterm infants before, during, and after a 2-h period of KMC at a mean postnatal age of 36 ± 21 days of life. We found that rSO₂L, rSO₂C, FOEL, and FOEC did not change in our patients. After 120 min of KMC, rSO₂L was lower (71.3 ± 1.4 vs. 76.7 ± 4.6%; P = 0.012) in infants with BPD (n = 6; 30%) than in infants without BPD (n = 14 = 60%), while FOEL was higher (0.26 ± 0.02 vs. 0.20 ± 0.05; P = 0.012).Conclusion: Cerebral and lung oxygenation did not change in preterm infants during KMC. A transient decrease in lung oxygenation was offset by the increase in oxygen extraction, but these changes were clinically insignificant. These results confirm the safety of KMC in preterm infants who are in stable clinical conditions. What is Known • Kangaroo mother care (KMC) is widely used to improve the care of preterm newborns since it improves their outcome. • KMC is safe as patients' vital parameters, are not negatively affected, but lung function has never been directly assessed. What is New • Cerebral and lung oxygenation measured by near-infrared spectroscopy did not change during KMC. • A transient decrease in lung oxygenation compensated for by the increase in oxygen extraction occurred only in infants with BPD, but these changes were clinically insignificant.

Keywords: Kangaroo mother care; Lung oxygenation; Near-infrared spectroscopy; Preterm infants.

Fig. 1

Changes in a lung (rSO₂L) and b cerebral (rSO₂C) oxygenation, c lung (FOEL) and d cerebral (FOEC) fractional oxygen extraction ratio, e cerebro-pulmonary oxygenation ratio (CPOR), and f heart rate at the different data points of the study. Mean ± (SD)

Fig. 2

Changes in lung oxygenation (rSO₂L) in the total population and in infants with or without bronchopulmonary dysplasia (BPD)