Negative Outcomes
Update: 2/5/10 & 6/26/2012
Be sure to see Life
Threatening chart for ALTES and Deaths in Birth KC
Bauer, Pyper et al., 1998
Bauer J et al.,1996
Bohnhorst et al., 2001
27 weekers who got KC lost body temp. 28 or more weekers do not.
25-27 weekers lost body temp, 28 weeker or more do not.
Proportion of regular breathing decreased in 2 nd hour of KC, possibly
due to heat stress, even though temp in 2nd hour was still < 37.4
SSC is associated with an increased rate of bradycardia
+desaturation/hr (a combined value) but no increase in bradycardias
alone. Desats alone increased insignificantly during KC. Increased rate
is not associated with overheating (pg. 500). “Increase in.brady + desat
rate was not as great as in previous study because nurses made sure
airway was unobstructed” (pg. 500). KC was associated with less
regular breathing, probably due to brady + desat rate or parental
movement interference (pg. 501).
Mean axillary temp dropped 3/10 of a degree- due to no control over
Insulation clothing across the infants’ backs.
FT, descriptive of 7 neonatal deaths (5 in KC) over 5.5 years in France.
PT, RCT, of KC early after birth and intermittent over next five days.
Lower play/teaching NCAST score in KCs at 6 months.
FT, infants who needed resuscitation while in Birth KC
May be negative finding, will check it out???
Accidental extubation of one infant during ventilated KC
15 minutes of wriggling around when first put in KC with
Substance abusing moms.
PT, LBW, some mothers had problems adjusting to KMC but preferred
it to incubator care. MATERNAL PROBLEM, not infant.
PT, case study of one baby who desated during KC and did not in
incubator.
FT, reports what happened in Japan of death during birth KC
FT/Late Preterm Cochrane concluded that “KC no apparent short- or
long-term negative effects.”
PT, RCT of early vs. late 24/7 KMC beginning within 24 hours of birth
in stable premature infants. No difference in adverse events between
the groups by discharge in Madagascar.
FT, report of sudden infant death after Birth KC with full terms.
FT, 2 case studies of apneic, hypotonic, pale infants at 5 and 70 mins
post birth.
Desaturations occur during transfer into/out of ventilated KC
Recommendations for WHO to adopt related to KMC in NICU in
developed countries and says that apnea, desats, and bradys with
handling, routine care, or transfer into KC are obstacles to doing KMC.
Recommendations from 7th INK meeting and says that instability is an
obstacle to KMC
PT, RCT, in India and 1 KMC and 5 controls died during study.
PT, KMC is a risk factor for methicillin resistant staph aureus.
Though no sig diff between groups, she goes on and on about how
Temperature changes more than 0.1degree per hour and that is temperAture instability, and desats occur in 2nd hour of KC with BPD infants
Though no sig diff between groups, she elaborates on how bad a 3
Point drop in low frequency HRV could be and that KC is stressful.
Signal detection of apnea may be masked by maternal respiration if
Electrode is on front of chest beneath mother instead of in infant axilla
Suffocation by sleeping mothers of two babies and lack of good support
From the slings in others.
Bohnhorst et al., 2004
Bosque et al., 1995
Branger et al., 2007
Chiu & Anderson, 2009
Dageville et al., 2008
Diaz-Rosello et al., 1990
Drosten-Brooks,1993
Gale, Franck, Lund, 1993
Ibe et al., 2004
Jarrell et al., 2009
Mori et al., 2008/2009
Moore et al., 2012
Nagai, et al., 2010
Nakamura et al., 2007
Nakamura & Sano, 2008
Neu et al., 2000
Nyqvist, 2009
Nyqvist et al., 2009
Rao et al., 2008
Sakaki et al., 2009
Smith,2001
Smith 2002
Sontheimer et al.,1995
Van den Bosch& Nhaine, 1993
Visser et al., 2008
Wieland et al., 1995
PT, Descriptive of 23 preterms on 24/7 KMC ward in South Africa
who got nosocomial RSV associated pneumonia due to inadequate
infection control by staff and mothers.
Of 167 first KC sessions of 30 minutes duration, KC had to be stopped
for infant restlessness 5 times, for increasing apnea/bradycardia 4
times, for hypothermia 3 times, and for rapidly increasing FiO2 needs
one time. Also, of 16 infants with elevated inspiratory oxygen need
before KC, 13 infants needed more FiO2 during 30 minutes of KC
(babies were 25-32 wk GA tested at 28 wks with wgts of 740-2125 grm
with mean of 1110 gram on day 10 of life) .