Kangaroo Care on High-Frequency Jet Ventilation: Overcoming Perceived Barriers in Micro Preemies with Birth Weights Less than 750 Grams

TL;DR

This study shows that kangaroo care can be safely provided to extremely low birth weight preterm infants on a specific type of ventilation.

Contribution

The study demonstrates the feasibility of kangaroo care in micro preemies on high-frequency jet ventilation, overcoming prior assumptions about instability.

Findings

No significant changes in heart rate or temperature during kangaroo care sessions in micro preemies.

Improved oxygen saturation and reduced need for supplemental oxygen after kangaroo care.

Extended kangaroo care sessions up to 2.3 hours did not negatively affect outcomes.

Abstract

Objective: Kangaroo care (KC) is underutilized in preterm infants on ventilator support due to perceived physiologic instability. The objective of our study is to demonstrate the feasibility of safe KC provision on high-frequency jet ventilation (HFJV) in micro preemies weighing less than 750 g. Study Design: Our neonatal intensive care unit has a multidisciplinary clinical standard for KC while preterm infants are on HFJV (HFJV-KC). Bedside staff documented cardiorespiratory and physiologic parameters pre, during, and post HFJV-KC. We performed a retrospective assessment of the feasibility of HFJV-KC in the micro preemie population. Results: A total of 96 HFJV-KC occurrences from 13 neonates with median gestational age 24 1/7 weeks and birth weight of 670 g were included. There were no significant differences in heart rate and temperature pre, during, and post-HFJV-KC. There were statistically significant improvements in oxygen saturation and fraction of inspired oxygen post HFJV-KC. Secondary analyses of prolonged HFJV-KC beyond 1 h (mean 2.3 h) compared to the standard 1 h duration also showed no differences in outcome measures. Conclusions: This study demonstrates that KC may be performed in the smallest micro preemie infants (<750 g) on HFJV. Our study also presents processes to overcome perceived barriers of HFJV-KC implementation in a vulnerable population.

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