Kangaroo care and ventilator Vakiliamini M.MD

HISTORY Rey and Martinez (1978-1983) in Bogotá, Columbia About 4 million babies die each year in the first week of life, KMC could help 25% survive WHO : benefits of KC offer than an alternative to incubator care in USA, only 45% t offered KC to parents of infants who were on a ventilator, while 73% offered parents to participate in KC with infants who were not on a ventilator

Eligibility criteria 1. Stable neonates of 27 weeks post menstrual age or more are eligible. Stable means no deterioration of condition within 24 hours before skin-to-skin contact. 2. All neonatal lines and tubes must be well secured. 3. Neonatal respiratory support in the form of oxygen supplementation to include mechanical ventilation, vapotherm or nasal cannula is not contraindication 4. Parents should be educated in skin-to-skin contact process and willing to provide for at least one hour.

Infants not eligible for skin to skin care 1. Any infant with a chest tube. 2. Any infant with an intracardiac line. 3. Any infant with an arterial line. 4. Any infant who is being actively weaned from a ventilator or is 2 hours post extubation. 5. Any infant who has an acute or sudden deterioration in condition within the past 24 hr 6. infant on oscillating, jet and NO ventilation 7. Parents with rashes or open skin lesions or URI 8. Any infant requiring vasopressor medications.

Barriers to Kangaroo Care with ventilated neonates in practice Fear of arterial or venous line dislodgement Fear of accidental extubation Safety issues for very low birthweight infants Inconsistency in technique Nurses’ feelings that their work load increased. Nursing reluctance. CONT

Barriers to Kangaroo Care with ventilated neonates in practice Medical staff reluctance Difficulty administering care during KC Staff concerns for parental privacy Lack of experience with KC Insufficient time for family care during KC Belief that technology is better than KC

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