| Citations | Abstract | keywords |
| Lisanti AJ, Buoni A, Steigerwalt M, Daly M, McNelis S, Spatz DL. Kangaroo care for hospitalized infants with congenital heart disease. MCN Am J Matern Child Nurs. 2020;45(3):163–168. doi: 10.1097/NMC.0000000000000612. | Background: Kangaroo care (KC) has many benefits but was not routine in our cardiac center. This project aimed to support KC as a nursing intervention. Methods: A QI committee formed to develop strategies, including a new policy, EHR adaptation, education, and a “Kangaroo-A-Thon.” Results: 26 nurses initiated KC 43 times with 14 patients. No adverse events were reported. Conclusion: KC can be safely integrated into standard care for hospitalized infants with CHD. Formal standards and creative initiatives can foster translation into practice. | Congenital heart disease, kangaroo care, skin-to-skin care, quality improvement, parents, nursing education |
| Lisanti AJ, Demianczyk AC, Costarino A, Vogiatzi MG, Hoffman R, Quinn R, et al. Skin-to-skin care is associated with reduced stress, anxiety, and salivary cortisol and improved attachment for mothers of infants with critical congenital heart disease. J Obstet Gynecol Neonatal Nurs. 2021;50(1):40–54. doi: 10.1016/j.jogn.2020.09.154. | Objective: To estimate the effect of skin-to-skin contact (SSC) on biobehavioral measures of stress and attachment of mothers before and after their infants’ neonatal cardiac surgery. Results: Findings provide initial evidence of the benefits of SSC as a nurse-led intervention to support maternal attachment and reduce physiologic and psychological stress responses (anxiety and salivary cortisol) in mothers of infants with critical CHD. | Congenital heart disease, skin-to-skin care, maternal stress, anxiety, salivary cortisol, attachment, mothers |
| Lisanti AJ, Demianczyk AC, Costarino A, Vogiatzi MG, Hoffman R, Quinn R, et al. Skin-to-skin care is a safe and effective comfort measure for infants before and after neonatal cardiac surgery. Pediatr Crit Care Med. 2020;21(9):e834–e841. doi: 10.1097/PCC.0000000000002493. | Objective: To determine the effect of SSC on stress, pain, behavioral organization, and physiologic stability of infants with critical CHD. Results: Infant pain scores significantly decreased and infants moved into a calmer behavior state during SSC compared to baseline. Preoperatively, infants had reduced heart rate and respiratory rate during SSC. Cortisol remained stable during SSC but increased post-SSC. Conclusions: SSC is a low-cost, low-risk intervention that promotes comfort and supports physiologic stability. | Congenital heart disease, skin-to-skin care, pain, stress, physiologic stability, cortisol, cardiac surgery |
| Gazzolo D, Masetti P, & Meli M. Kangaroo care improves post-extubation cardiorespiratory parameters in infants after open heart surgery. Acta Paediatrica. 2000;89(6):728–729. doi: 10.1080/080352500750044098 | Summary: This brief report investigates the effects of Kangaroo Care (KC) on infants following open-heart surgery. The study found that KC significantly improved post-extubation cardiorespiratory parameters (including heart rate, respiratory rate, and oxygen saturation) compared to standard care, suggesting it is a feasible method for stabilizing infants in the cardiac postoperative period. | |
| Harrison TM. Improving neurodevelopment in infants with complex congenital heart disease. Birth Defects Research. 2019;111(15):1128–1140. doi: 10.1002/bdr2.1517 | Abstract: Infants with complex CHD are at high risk for neurodevelopmental impairments. This review synthesizes current literature on the developmental risks for this population and proposes that interventions successful in other high-risk neonatal populations, such as skin-to-skin contact, may be adapted to improve neurodevelopmental outcomes in infants with CHD. The article highlights the need for early intervention to mitigate risks associated with cardiac physiology and the ICU environment. | |
| Harrison TM, & Brown R. Autonomic nervous system function after a skin-to-skin contact intervention in infants with congenital heart disease. Journal of Cardiovasc Nursing. 2017;32(5):E1–E13. doi: 10.1097/JCN.0000000000000397 | Objective: To examine feasibility of a 2-week daily SSC intervention and describe changes in ANS function. Results: Recruitment was 72%; retention 55.5%. Mothers were universally positive. Ten mothers/infants completed the protocol with no adverse events. Linear measures of heart rate variability (HRV) suggested improvements in ANS function. Non-linear measures demonstrated abnormally high sympathetic activity. Conclusions: SSC is feasible and safe; linear HRV suggests ANS improvement. | |
| Harrison TM, Chen CY, Stein P, Brown R, & Heathcock JC. Neonatal skin-to-skin contact: Implications for learning and autonomic nervous system function in infants with congenital heart disease. Biological Research for Nursing. 2019;21(3):296–306. doi: 10.1177/1099800419827599 | Background: CHD infants often develop neurodevelopmental disabilities. Methods: Secondary data analysis measuring cognitive function using the mobile paradigm (learning task) and ANS function (HRV) at 3 months. Results: Learning rates were higher in the cardiac-SSC group (70%) compared to the cardiac-control group (40%). Learners demonstrated significant reductions in HRV during the task (appropriate modulation). Conclusions: Findings suggest improvements in cognitive and autonomic development in 3-month-old infants with CHD who received neonatal SSC. | |
| Harrison TM, & Ludington-Hoe S. A case study of infant physiologic response to skin-to-skin contact after surgery for complex congenital heart disease. Journal of Cardiovascular Nursing. 2015;30(6):506–516. doi: 10.1097/JCN.0000000000000202 | Objective: To describe the physiologic response to a single session of SSC in an 18-day-old infant with hypoplastic left heart syndrome (HLHS) post-surgery. Results: Repeated measures of heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature were recorded. All physiologic parameters remained clinically acceptable throughout the 135-minute observation. Conclusion: Provides beginning evidence that SSC is safe in full-term infants following surgery for complex CHD. | |
| Lisanti AJ, Golfenshtein N, & Medoff-Cooper B. The pediatric cardiac intensive care unit parental stress model: Refinement using directed content analysis. Advances in Nursing Science. 2017;40(4):319–336. doi: 10.1097/ANS.0000000000000184 | Abstract: This qualitative study used directed content analysis to explore parental stress for mothers of infants with complex CHD in the PCICU. The PCICU Parental Stress Model was used as the framework. Data from three focus groups with 14 mothers provided themes to support and refine the model (classifying stressors into infant, parent, and environment). The refined model can guide practice and future research. | |
| Lisanti AJ, Vittner D, Medoff-Cooper B, Fogel J, Wernovsky G, & Butler S. Individualized family-centered developmental care: An essential model to address the unique needs of infants with congenital heart disease. Journal of Cardiovascular Nursing. 2019;34(1):85–93. doi: 10.1097/ JCN.0000000000000546 | Purpose: To describe the uniqueness of the CHD infant (medical/neurological/parental challenges) and propose methods to apply Individualized Family-centered Developmental Care (IFDC) to support recovery in the CICU. Conclusions: CICU experiences can alter brain development. IFDC is a promising model to minimize the mismatch between infant neurobiological needs and the CICU environment. Nurses can integrate IFDC to promote neuroprotection and development. | |
| Ludington-Hoe SM. Thirty years of kangaroo care science and practice. Neonatal Network. 2011;30(5):357–362. doi: 10.1891/0730-0832.30.5.357 | Abstract: This review summarizes 30 years of Kangaroo Care (KC) science. It details the established benefits of KC, including improved physiologic stability (heart rate, respiration, temperature), increased breastfeeding rates, and better sleep cycles contributing to brain maturation. Despite clear evidence of efficacy and safety, the article notes that KC remains underutilized in many neonatal settings and calls for standardized education and implementation. | |
| Torowicz DL, Seelhorst A, Froh EB, & Spatz DL. Human milk and breastfeeding outcomes in infants with congenital heart disease. Breastfeed Med. 2015;10(1):31–37. doi: 10.1089/bfm.2014.0059 | Abstract: This article summarizes evidence on breastfeeding infants with CHD. It discusses barriers (concern for dysphagia, weight gain, clinical instability) and facilitators. The authors conclude that current evidence does not support automatic withholding of breastfeeding; benefits likely outweigh concerns. Critical gaps in research and practice are identified to improve breastfeeding care in this population. |