Objective To evaluate the maternal satisfaction and the clinical effect of kangaroo mother care (KMC) in preterm infants. Methods We searched PubMed, EMBASE, Ovid, Springer, CNKI, CBM and Taiwan Database of Journal Fulltext (from establishment to September 2007) and hand searched relevant conference proceedings to identify randomized controlled trials on kangaroo mother care. The quality of included trials was assessed. Meta-analyses were conducted using The Cochrane Collaboration’s RevMan 4.2 software. Results A total of 5 eligible studies were included. No significant differences were observed in infant mortality, incidence of severe infections, and psychomotor development at 12 months (corrected for age) between the KMC group and the routine therapy group (Pgt;0.05). Compared to the routine therapy group, the KMC group had lower incidences of nosocomial infection, upper respiratory tract disease at 6-month follow-up and not exclusively breastfeeding at discharge (Plt;0.05). KMC could improve mother’s sense of competence during her baby’s stay in hospital and NICU, increase infant weight at discharge, relieve mother’s feelings of worry and stress during her baby’s stay in hospital (Plt;0.05). Conclusions The currently published evidence from randomised trials supports the use of KMC in preterm infants, which is a scientific, effective and humanistic nursing model. Further multicentre and large-scale randomized controlled trials of KMC are still needed to evaluate its potential influence on infant mortality and psychomotor development.
Objective To make an individualized treatment plan concerning a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension. Methods Based on the clinical questions raised by a newborn with meconium aspiration syndrome combined with persistent pulmonary hypertension, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1980 to June 2009), ACP Journal Club (1991 to June 2009), and Chinese Journal Fulltext Database (1994 to June 2009) for systematic reviews, randomized controlled trials (RCTs) and case-control studies. The quality of the included studies was assessed. Results A total of 9 RCTs, 1 health economic evaluation, 1 meta analysis, and 2 systematic reviews were considered eligible. The evidence indicated that the use of ECMO in infants of PPHN had shown a decreased risk of death, but not cost-saving from a societal perspective; iNO treatment could improve the PaO2 and resulted in a reduction in the incidence of requirement for ECMO; there were not randomized controlled trials regarding the treatment of PPHN by hyperventilation, high-frequency ventilation, alkali infusion, pulmonary vasodilators (magnesium sulfate, tolazoline, prostaglandin or prostacyclin, milrinone), surfactant therapy; oral sildenafil could lower oxygenation index (OI) and result in a reduction in the incidence of death. The individualized treatment plans of oral sildenafil were developed based on the available evidence, existing conditions of the hospital, and the values of children with families. After 1 month of treatment, the FiO2 returned to normal and symptoms were alleviated. Conclusion The treatment efficacies and the survival rates in meconium aspiration syndrome combined with PPHN have been improved by determining an individualized treatment plan according to evidence-based methods.