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Objective:  This study aimed to assess thermoregulation and humidity within the Skincubator-a novel, wearable skin-to-skin incubator designed to attach to the caregiver., Study Design:  Preterm neonates (PN; born between 24 and 33 weeks gestational age [GA]) received skin-to-skin care (SSC) either via the Skincubator or traditional SSC (t-SSC) with continuous axillary temperature monitoring., Results:  Twenty PN were enrolled in the study and treated in the Skincubator. One couple who consented to Skincubator care during delivery subsequently revoked their consent and the baby was excluded from further analysis. Fifty-four paired sessions of Skincubator and t-SCC were performed and compared for 19 babies. The average GA was 29 weeks (range: 26-32), the average weight was -1,296 ± 271 g, and the average day of life was 5 ± 2. The temperature drop after transfer to Skincubator care was smaller than in t-SSC (0.2°C [0.2-0.3] vs. 0.4°C [0.3-0.6]; Wilcoxon's signed rank test [WSRT], p  < 0.001). The average hypothermia time per session was a median (25th-75th%) of 8.2 minutes (0-9) for Skincubator, compared to 27.8 minutes (0-56) for t-SSC, respectively (WSRT, p  = 0.002). No baby had moderate hypothermia (35.5-35.9°C) during Skincubator care as compared with eight babies who experienced moderate hypothermia during t-SSC (Fisher's exact test p  = 0.003). The average Skincubator humidity was 85 ± 7% and was above 70% during 93% of the time., Conclusion:  Skincubator SSC was superior to t-SSC in maintaining PN temperature while also maintaining an optimally humidified environment. The Skincubator may promote early SSC in very and extremely PN. (Trial registration number MOH&#95;2021-12-13&#95;010470 registration date 24/10/21.) KEY POINTS: · Early prolonged SSC improves preterm infants' outcomes but may be challenging to perform.. · To mitigate several SSC barriers we invented the Skincubator, a wearable incubator for SSC.. · We have shown that the Skincubator reduces transient moderate hypothermia at SSC initiation.. · Average Skincubator humidity was 85 ± 7% and above 70% during 93% of SSC time.., Competing Interests: I.N. is the inventor of the Skincubator and a founder and the chief medical officer of Skincubator Neocare, a company founded to develop the Skincubator and bring it to clinical use. He and Skincubator Neocare have submitted patents regarding the Skincubator system. Other authors do not have any conflict of interest., (Thieme. All rights reserved.)

Objective: The study aimed to assess the association of nucleated red blood cells (NRBC), a surrogate of intrauterine hypoxia, and elevated pulmonic vascular resistance (E-PVR) and oxygen requirement after minimally invasive surfactant therapy (MIST)., Study Design: Retrospective study of a cohort of preterm neonates that received MIST in a single unit., Results: NRBC were measured in 65 of 75 (87%) neonates administered MIST during the period. In total, 22 of 65 (34%) infants had pre-MIST echocardiography (ECHO).Neonates with elevated NRBC (predefined as >5 × 10 9 /L, n  = 16) required higher post-MIST fraction of inspired oxygen (FiO 2 ) than neonates with normal NRBC (<1 × 10 9 /L, n  = 17; FiO 2  = 0.31 ± 0.10 and 0.24 ± 0.04, respectively, p  = 0.02).NRBC correlated positively with % of time in right to left ductal shunt (r = 0.51, p  = 0.052) and inversely with right ventricular stroke volume (r = -0.55, p  = 0.031) and time to peak velocity to right ventricular ejection time ratio (r = -0.62, p  < 0.001)., Conclusion: Elevated NRBC are associated with elevated FiO 2 after MIST and elevated E-PVR. Intrauterine hypoxia may impact postnatal circulatory adaptations and oxygen requirement., Key Points: · Post-MIST FiO2 requirements are significantly higher in infants with elevated NRBC.. · NRBC correlates positively with elevated PVR in neonates requiring.. · Intrauterine hypoxia may play a role in postnatal circulatory adaptations in neonates with RDS.., Competing Interests: None declared., (Thieme. All rights reserved.)

Introduction: Several echocardiographic scoring systems have been developed to assess the severity of patent ductus arteriosus (PDA) shunting in preterm infants., Objective: The objective of this study was to compare the ability of two different scoring systems to evaluate the hemodynamic significance of the PDA and to predict long-term PDA-associated morbidities., Subjects: El-Khuffash cohort (previously described) was derived from a multicenter, prospective, observational study conducted in tertiary neonatal intensive care units in Ireland, Canada, and Australia., Results: A total of 141 infants with a mean gestational age of 26 ± 1.4 weeks and a mean birth weight of 952 ± 235 g were evaluated on day 2 of life. The two scores were well correlated with each other and both scores positively predicted chronic lung disease/death in this population., Conclusion: There appears to be an overall stepwise progression in the incidence of poor outcome parameters from "closed" to "borderline" to "hemodynamically significant" PDA. Both the El-Khuffash and Shaare Zedek scores are predictive of PDA-associated morbidities., Competing Interests: Conflict of Interest: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)