Efeitos do cuidado Mãe Canguru nos sinais vitais dos recém-nascidos prematuros com peso inferior a 1.500 gramas em ventilação mecânica

Abstract

The kangaroo mother care (KMC) is still controversial when explored in premature newborns (PN) weighting less than 1,500g in mechanical ventilation, because there are few studies on international literature and there is no study about this on national literature. So, seeking to help the approach of mother and child earlier and to analyze the possibility of KMC in PN with very low and extreme low birth weight on mechanical ventilation, this study was to consider the vital signs and to describe the behavioral response of PN weighing less than 1,500g, intubated and haemodynamically stable in KMC per 1 hour. A quasi-experimental study, did at Neonatal Intensive Care Unit of Sofia Feldman Hospital, were analyzed 44 PN (sample power >0,9), with 25 male and mean of gestational age of 29,1 weeks. PN were evaluated during ninety minutes, with fifteen minutes before, one hour during and fifteen minutes after KMC. The outcome variables heart rate, mean arterial blood pressure, skin temperature and inspirated oxygen fraction were analyzed using longitudinal data (variation of 3 to 11 sequential data), through uni- and multivariate analyses. The behavioral response (Brazelton, 1995; Holditch-Davis; 1990) was evaluated before, during and after intervention and analyzed using qui-square test and Fisher test. The study was approved by UFMGs (311/07) and Sofia Feldmans (nº 07/2007) Research Ethical Committees (311/07 and 07/2007). The outcome variables showed a statistical significant difference (p<0.05) when compared longitudinally. However, the results were not clinically significant (variance < 5% from base). Besides, the KMC encouraged the behavioral state of sleep, especially deep sleep. So, the interpretation of the results show that KMC can be a safe method in the conditions of this study and its use is promising in encouraging mother-child bonding early and seems to be an important tool for neurobehavioral development, since it encouraged the behavioral state of sleep, especially deep sleep.