1. Kangaroo care and ventilator
Vakiliamini M.MD

2. 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

3. 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.

4. 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.

5. 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

6. 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

22. Thank you