Bradycardia and desaturation during skin-to-skin care: No relationship to hyperthermia

Abstract

We recently found increased temperature and increased bradycardia and desaturation during skin-to-skin care (SSC). We wanted to determine if these effects were related. Twenty-two infants (median gestational age at birth 28.5 weeks [range 24-31], median age at study 25.5 days [range 10-60 days], median birth weight 1025 g [range 550-1525 g], median weight at study 1320 g [range 900-2460 g]) underwent three 2-hour recordings of breathing movements, nasal airflow, heart rate, and pulse oximeter saturation (SpO 2 ): at thermoneutrality (TN) during incubator care, at TN during SSC, and at elevated temperature (ET) during incubator care. Core temperature was measured via a rectal probe. Recordings were analyzed for the summed rate of bradycardia and desaturation (heart rate <2/3 of baseline; SpO 2 <or=80%). Rectal temperature remained unchanged during SSC and increased by 0.6 degrees C during ET ( P < .001). The summed rate of bradycardia and desaturation was increased during SSC but not during ET (TN: median 2.2/hour (range, 0-19), ET: median 1.7/hour (range, 0-13), SSC: 3.0/hour (0-25), P < .02 SSC vs ET). Bradycardia and desaturation were increased during SSC, even at constant rectal temperature, whereas ET had no effect on these events. Moderate hyperthermia did not increase respiratory instability in preterm infants.