149 - The Skincubator: A novel device for early prolonged skin-to-skin-care (SSC) for very and extreme preterm neonates, improves thermoregulation during SSC.

Poster Number: 149
Publication Number: 149.1767

Background: Skin-to-skin care (SSC) reduces morbidity and mortality in preterm neonates (PN). However, extreme PN are generally ineligible for early, prolonged SSC for several reasons, including the need to regulate humidity levels using incubators and line dislodgment concerns. To enable continuous SSC in this population, we invented the Skincubator, a small incubator designed to attach to the caregiver’s torso without any barrier between the parent's chest and the baby (figure 1). The Skincubator enables SSC within an environment with all neonatal incubator advantages.

Objective: To assess whether performing SSC within a heated and humidified environment will result in better thermoregulation.

Design/Methods: A safety trial aimed at measuring humidity within the Skincubator and studying thermal stability during Skincubator sessions compared to traditional SSC (t-SSC) sessions.
Population: PN, gestational ages (GA) 26-33 weeks were studied from birth; babies GA 24-28 wks. were studied from day of life 4. Exclusion criteria included invasive ventilation, arterial line, and cardiovascular instability.

Results: Twenty PN were enrolled in the study and treated in the Skincubator. One couple consented to Skincubator care during delivery but did not consent to Skincubator care in the NICU and was excluded from further analysis. We compared 54 paired sessions of Skincubator and t-SCC performed on 19 babies. Demographics are presented in Table 1.
No safety issues occurred during Skincubator care. Average humidity in the Skincubator was 85%±7% and was within the target range (above 70%) during 93.4% of the time. Nine babies had central lines (PICC or umbilical vein catheter). No line dislodgment or other adverse events occurred during Skincubator care or T-SSC. No baby had moderate hypothermia during Skincubator care. Eight babies experienced moderate hypothermia of 35.5-35.9 during nine t-SSC sessions (chi-square p< 0.001).
The temperature drop from pre-SSC was smaller in the Skincubator than in t-SSC. During Skincubator care, babies had less hypothermia (defined as axillary temperature < 36.5º) than during t-SSC. This was statistically significant when analyzed per baby (n=19) or per session (n=54). Results are presented in Tables 2 and 3.

Conclusion(s): The Skincubator can effectively create a humidified, warm environment on the human body for PN SSC. In our study, the Skincubator was superior to t-SSC in maintaining PN temperature. This may be of clinical significance in extreme PN in the first weeks of life. The Skincubator may help promote early SSC for very and extreme PN.