Document Detail

Improved outcome of extremely low birth weight infants with Tegaderm application to skin.
MedLine Citation:
PMID:  15703777     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Significant fluid and electrolyte disturbances occur in extremely low birth weight (ELBW) infants in the first few days of life. We investigated the effect of semipermeable polyurethane membrane (Tegaderm) applied to the skin shortly after birth on fluid and electrolyte status and the clinical outcome in these infants. STUDY DESIGN: We reviewed charts of ELBW infants (BW<1.0 kg) born during 24 months prior to Tegaderm application and 19 months after starting Tegaderm. Data were collected daily from the first week of life and additional clinical morbidities were compared. RESULTS: A total of 39 infants from pre-Tegaderm period (NOTEG) (mean+/-SD, BW 756+/-158 g, GA 26.1+/-1.9 weeks) were compared to 30 infants with extensive Tegaderm application to chest, abdomen and extremities (TEG) (BW 802+/-160 g, GA 26.3+/-1.8 weeks). The groups were similar in maternal demographics as well as postnatal surfactant use. Throughout the first week of life, serum Na levels, daily fluid intake and daily weight loss were significantly higher in the NOTEG infants (all P< or =0.04) while BUN/Serum creatinine levels were similar. Hypernatremia (Na>150 mEq/l) developed in 51% of NOTEG infants compared to 17% of TEG (P=0.0005) and daily fluid intake > or =170 ml/kg/day was required in 54 vs 13% (P=0.0008), respectively. The mean time to regain BW was significantly longer in NOTEG vs TEG infants, 20.7+/-7.4 vs 15.8+/-6.3 days, respectively (P<0.02). There were no statistical significant differences among the groups in incidence of IVH, NEC, PDA or nosocomial sepsis; however, respiratory outcome was better in TEG infants. They had significantly less BPD (58% in NOTEG vs 22% TEG (P=0.01)) and fewer infants in the TEG group required supplemental oxygen at discharge (58% vs 22% (P=0.01)). Survival was significantly higher in TEG 90% vs 64% in NOTEG infants (P=0.02). CONCLUSIONS: Semipermeable polyurethane membrane application to skin of ELBW infants shortly after birth decreased postnatal fluid and electrolyte disturbances and significantly improved their outcome by reducing severity of lung disease and decreasing mortality.
Vineet Bhandari; Nancy Brodsky; Rachel Porat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  25     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-24     Completed Date:  2005-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  276-81     Citation Subset:  IM    
Division of Neonatology, Department of Pediatrics, Albert Einstein Medical Center, Philadelphia, PA, USA.
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MeSH Terms
Infant, Newborn
Infant, Very Low Birth Weight*
Retrospective Studies
Skin, Artificial*
Sodium / blood
Water Loss, Insensible
Water-Electrolyte Balance*
Reg. No./Substance:

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