Iatrogenic Skin Disorders and Related Factors in Newborn Infants

Csoma, Zsanett; Meszes, Angéla; Ábrahám, Rita; Kemény, Lajos; Tálosi, Gyula; Doró, Péter

doi:10.1111/pde.12960

Cited by 19 publications

(11 citation statements)

References 22 publications

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“…However, prematurity, and BPD as a syndrome, encompass not only disturbances to lung development but also pathological involvement of the retina (in ROP) (203) and the musculature (541) and acute kidney injury (34,35) and are complicated by adverse neurodevelopmental outcomes (28,37,524,579), where hyperoxia per se impacts the development of the central nervous system (444). The liver has recently been recognized as a player in parturition and preterm birth (338), and iatrogenic skin disorders have been noted in preterm infants with BPD (113).…”

Section: Extrapulmonary Considerationsmentioning

confidence: 99%

Recent advances in our understanding of the mechanisms of late lung development and bronchopulmonary dysplasia

Solaligue

Rodríguez‐Castillo

Ahlbrecht

et al. 2017

American Journal of Physiology-Lung Cellular and Molecular Phys

126

102

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The objective of lung development is to generate an organ of gas exchange that provides both a thin gas diffusion barrier and a large gas diffusion surface area, which concomitantly generates a steep gas diffusion concentration gradient. As such, the lung is perfectly structured to undertake the function of gas exchange: a large number of small alveoli provide extensive surface area within the limited volume of the lung, and a delicate alveolo-capillary barrier brings circulating blood into close proximity to the inspired air. Efficient movement of inspired air and circulating blood through the conducting airways and conducting vessels, respectively, generates steep oxygen and carbon dioxide concentration gradients across the alveolo-capillary barrier, providing ideal conditions for effective diffusion of both gases during breathing. The development of the gas exchange apparatus of the lung occurs during the second phase of lung development-namely, late lung development-which includes the canalicular, saccular, and alveolar stages of lung development. It is during these stages of lung development that preterm-born infants are delivered, when the lung is not yet competent for effective gas exchange. These infants may develop bronchopulmonary dysplasia (BPD), a syndrome complicated by disturbances to the development of the alveoli and the pulmonary vasculature. It is the objective of this review to update the reader about recent developments that further our understanding of the mechanisms of lung alveolarization and vascularization and the pathogenesis of BPD and other neonatal lung diseases that feature lung hypoplasia.

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Section: Extrapulmonary Considerationsmentioning

confidence: 99%

Recent advances in our understanding of the mechanisms of late lung development and bronchopulmonary dysplasia

Solaligue

Rodríguez‐Castillo

Ahlbrecht

et al. 2017

American Journal of Physiology-Lung Cellular and Molecular Phys

126

102

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“…This conventional setup of cardiorespiratory monitoring has several disadvantages. First, the electrodes may cause skin damage and discomfort and the wires may hinder parent−infant interaction, including kangaroo and nursing care 5 . Furthermore, CI may not always measure RR accurately due to nonbreathing related changes in impedance and cardiac interference 2,6 .…”

Section: Introductionmentioning

confidence: 99%

“…First, the electrodes may cause skin damage and discomfort and the wires may hinder parent−infant interaction, including kangaroo and nursing care. 5 Furthermore, CI may not always measure RR accurately due to nonbreathing related changes in impedance and cardiac interference. 2,6 Therefore, there is a need for a skin-friendly and wireless alternative that improves the RRmonitoring accuracy compared to CI by measuring respiration directly.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory monitoring with a wireless and nonadhesive belt measuring diaphragm activity in preterm and term infants: A multicenter non‐inferiority study

Scholten,

Zhan,

Niemarkt

et al. 2023

Pediatric Pulmonology

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IntroductionWe determined if the heart rate (HR) monitoring performance of a wireless and nonadhesive belt is non‐inferior compared to standard electrocardiography (ECG). Secondary objective was to explore the belt's respiratory rate (RR) monitoring performance compared to chest impedance (CI).MethodIn this multicenter non‐inferiority trial, preterm and term infants were simultaneously monitored with the belt and conventional ECG/CI for 24 h. HR monitoring performance was estimated with the HR difference and ability to detect cardiac events compared to the ECG, and the incidence of HR‐data loss per second. These estimations were statistically compared to prespecified margins to confirm equivalence/non‐inferiority. Exploratory RR analyses estimated the RR trend difference and ability to detect apnea/tachypnea compared to CI, and the incidence of RR‐data loss per second.ResultsThirty‐nine infants were included. HR monitoring with the belt was non‐inferior to the ECG with a mean HR difference of 0.03 beats per minute (bpm) (standard error [SE] = 0.02) (95% limits of agreement [LoA]: [−5 to 5] bpm) (p < 0.001). Second, sensitivity and positive predictive value (PPV) for cardiac event detection were 94.0% (SE = 0.5%) and 92.6% (SE = 0.6%), respectively (p ≤ 0.001). Third, the incidence of HR‐data loss was 2.1% (SE = 0.4%) per second (p < 0.05). The exploratory analyses of RR showed moderate trend agreement with a mean RR‐difference of 3.7 breaths/min (SE = 0.8) (LoA: [−12 to 19] breaths/min), but low sensitivities and PPV's for apnea/tachypnea detection. The incidence of RR‐data loss was 2.2% (SE = 0.4%) per second.ConclusionThe nonadhesive, wireless belt showed non‐inferior HR monitoring and a moderate agreement in RR trend compared to ECG/CI. Future research on apnea/tachypnea detection is required.

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“…The use of adhesive electrodes is restricted in infants with a postmenstrual age <26 weeks in fear of skin damage. 5 Moreover, electrode removal may cause discomfort. Furthermore, the wires attached to the electrodes restrict movements of the infant and may hinder parent-infant interaction, nursing and kangaroo care.…”

Section: Introductionmentioning

confidence: 99%

“…The use of adhesive electrodes is restricted in infants with a postmenstrual age <26 weeks in fear of skin damage 5. Moreover, electrode removal may cause discomfort.…”

Section: Introductionmentioning

confidence: 99%

Multicentre paired non-inferiority study of the cardiorespiratory monitoring performance of the wireless and non-adhesive Bambi® belt measuring diaphragm activity in neonates: study protocol

Scholten

Zhan

Niemarkt

et al. 2022

bmjpo

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IntroductionCardiorespiratory monitoring is used in the neonatal intensive care unit (NICU) to assess the clinical status of newborn infants and detect critical deteriorations in cardiorespiratory function. Currently, heart rate (HR) is monitored by electrocardiography (ECG) and respiration by chest impedance (CI). Disadvantages of current monitoring techniques are usage of wired adhesive electrodes which may damage the skin and hinder care. The Bambi® belt is a wireless and non-adhesive alternative that enables cardiorespiratory monitoring by measuring electrical activity of the diaphragm via transcutaneous electromyography. A previous study showed feasibility of the Bambi® belt and this study compares the belt performance to ECG and CI.Methods and analysisThis multicentre non-inferiority paired study will be performed in the NICU of the Máxima Medical Center (MMC) in Veldhoven and the Emma Children’s Hospital, Amsterdam University Medical Centre (AmsterdamUMC) in Amsterdam, The Netherlands. 39 infants in different postmenstrual age groups (minimally 10 infants<30 weeks, between 30–32 weeks and >32 weeks) will be recruited. These infants will be monitored with the Bambi® belt in addition to standard ECG and CI for 24 hours. The primary outcome is the HR, studied with three criteria: (1) the limits of agreement of the HR measurements in terms of the second-to-second difference in the HR between the belt and standard ECG, (2) the detection of cardiac events consisting of bradycardia and tachycardia and (3) the quality of HR-monitoring. The secondary outcome is the respiratory rate (RR), studied with the criteria (1) agreement in RR-trend monitoring, (2) apnoea and tachypnoea detection and (3) reliable registrations.Ethics and disseminationThis protocol was approved by the Medical Ethical Committee of the MMC and the Central Committee for Human Research. The MMC started patient recruitment in July and the AmsterdamUMC in August 2021. The results will be presented at conferences and published in peer-reviewed journals.Trial registration numberNL9480.

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Iatrogenic Skin Disorders and Related Factors in Newborn Infants

Abstract: To prevent ISIs, careful consideration of risk factors and the creation of protocols ensuring efficient treatment of injuries are needed.

Cited by 19 publications

References 22 publications

Recent advances in our understanding of the mechanisms of late lung development and bronchopulmonary dysplasia

Recent advances in our understanding of the mechanisms of late lung development and bronchopulmonary dysplasia

Cardiorespiratory monitoring with a wireless and nonadhesive belt measuring diaphragm activity in preterm and term infants: A multicenter non‐inferiority study

Multicentre paired non-inferiority study of the cardiorespiratory monitoring performance of the wireless and non-adhesive Bambi® belt measuring diaphragm activity in neonates: study protocol

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