Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas

Detalhes bibliográficos
Autor(a) principal: Gurgel, Eloah de Paula Pessoa
Data de Publicação: 2015
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/15734
Resumo: The neonatal population represents a strategic group as regards the reduction of infant mortality. Therefore, it becomes a challenge for the team assisting these patients to keep them stable with their vital functions in balance, since important changes occur during fetal life and after birth, especially in preterm infants. This study aimed to evaluate the efficacy of using the semipermeable membrane as technological resource applied in different areas of the preterm infants’ skin seeking to reduce transepidermal water loss. Seventy-two preterm infants underwent an experimental study, randomly distributed into four groups to receive the semipermeable membrane in different areas essential for application: thorax, abdomen and lower extremities. It took place at the Neonatal Intensive Care Unit (NICU) of the Maternity School Assis Chateaubriand (MEAC) in the city of Fortaleza, Ceará, Brazil. The sample consisted of preterm infants who met the following inclusion criteria: weight ≤ 1,500 grams and gestational age ≤ 32 weeks; remain in the unit for seven days; not show any severe malformations that affect skin integrity. We excluded infants with weakened health that prevented completion of the study; patients with congenital malformations, such as gastroschisis, omphalocele or myelomeningocele; and the consent given by parents and/or guardians of preterm infants. As outcome variables, we considered sodium, glucose, urine specific gravity, weight, and fluid loss. Gender and gestational age constituted the main variables of the experiment baseline. Fluid losses were measured with the aid of Tewameter applied to the skin of preterm infants, for 30 seconds. Data were compiled into Excel and statistical analysis with the software support R 2 version. 12. 1. In this study, we used a significance level of 5% and presented the data in tables. The ethical recommendations were followed during the research steps. Preterm infants were admitted to the Obstetric Center and the main medical diagnoses were prematurity, respiratory distress syndrome, and hyaline membrane disease. In total, preterm infants of the four groups were kept in humidified double walled incubators (100%), under mechanical ventilation (86.84%), nasal CPAP (7.89%), and use of intravenous hydration through central access (100%). They used antibiotics and parenteral nutrition (100%), enteral nutrition (7.89%), and phototherapy (68.42%). Applying the semipermeable membrane, soon after birth, was effective with regard to the maintenance of sodium, water quota, urine density, and glucose. Transepidermal loss was lower in the group that used the semipermeable membrane along the body extension, but it was not statistically different from those in which the membrane was applied to the thorax and abdomen (Group 3). In turn, this group presented lower blood glucose levels than the groups who had the membrane applied in the lower limbs and the thorax or abdomen (Groups 1, 2 and 3), but not different from newborns who used it along the body extension (Group 4). Furthermore, the intragroup changes observed in the following period among the six variables in study were similar in the four groups. This way, there are indications that using the semipermeable membrane applied to the thorax and abdomen may have a similar effect to its use along the body extension. Nonetheless, it should be noted that the small sample size might have contributed to failure to detect statistical differences, thus these results should be considered.
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spelling Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicasEffectiveness evaluation of the semipermeable membrane in the skin of preterm infants as technological resource to prevent transepidermal water lossRecém-NascidoPeleEnfermagemThe neonatal population represents a strategic group as regards the reduction of infant mortality. Therefore, it becomes a challenge for the team assisting these patients to keep them stable with their vital functions in balance, since important changes occur during fetal life and after birth, especially in preterm infants. This study aimed to evaluate the efficacy of using the semipermeable membrane as technological resource applied in different areas of the preterm infants’ skin seeking to reduce transepidermal water loss. Seventy-two preterm infants underwent an experimental study, randomly distributed into four groups to receive the semipermeable membrane in different areas essential for application: thorax, abdomen and lower extremities. It took place at the Neonatal Intensive Care Unit (NICU) of the Maternity School Assis Chateaubriand (MEAC) in the city of Fortaleza, Ceará, Brazil. The sample consisted of preterm infants who met the following inclusion criteria: weight ≤ 1,500 grams and gestational age ≤ 32 weeks; remain in the unit for seven days; not show any severe malformations that affect skin integrity. We excluded infants with weakened health that prevented completion of the study; patients with congenital malformations, such as gastroschisis, omphalocele or myelomeningocele; and the consent given by parents and/or guardians of preterm infants. As outcome variables, we considered sodium, glucose, urine specific gravity, weight, and fluid loss. Gender and gestational age constituted the main variables of the experiment baseline. Fluid losses were measured with the aid of Tewameter applied to the skin of preterm infants, for 30 seconds. Data were compiled into Excel and statistical analysis with the software support R 2 version. 12. 1. In this study, we used a significance level of 5% and presented the data in tables. The ethical recommendations were followed during the research steps. Preterm infants were admitted to the Obstetric Center and the main medical diagnoses were prematurity, respiratory distress syndrome, and hyaline membrane disease. In total, preterm infants of the four groups were kept in humidified double walled incubators (100%), under mechanical ventilation (86.84%), nasal CPAP (7.89%), and use of intravenous hydration through central access (100%). They used antibiotics and parenteral nutrition (100%), enteral nutrition (7.89%), and phototherapy (68.42%). Applying the semipermeable membrane, soon after birth, was effective with regard to the maintenance of sodium, water quota, urine density, and glucose. Transepidermal loss was lower in the group that used the semipermeable membrane along the body extension, but it was not statistically different from those in which the membrane was applied to the thorax and abdomen (Group 3). In turn, this group presented lower blood glucose levels than the groups who had the membrane applied in the lower limbs and the thorax or abdomen (Groups 1, 2 and 3), but not different from newborns who used it along the body extension (Group 4). Furthermore, the intragroup changes observed in the following period among the six variables in study were similar in the four groups. This way, there are indications that using the semipermeable membrane applied to the thorax and abdomen may have a similar effect to its use along the body extension. Nonetheless, it should be noted that the small sample size might have contributed to failure to detect statistical differences, thus these results should be considered.A população neonatal constitui um grupo estratégico no que se refere à diminuição da mortalidade infantil. Portanto, torna-se um desafio para a equipe que presta assistência a este paciente mantê-lo estável com suas funções vitais em equilíbrio, pois importantes mudanças ocorrem durante a vida fetal e após o nascimento, especialmente no recém-nascido prematuro (RNPT). Objetivou-se avaliar a eficácia do uso da membrana semipermeável como recurso tecnológico a ser utilizado em diferentes regiões da pele de RNPT para redução de perdas de água transepidérmicas. Um total de 72 RNPT foram submetidos a um estudo experimental e randomizados em quatro grupos para receberem a membrana semipermeável em diferentes regiões essenciais para aplicação: tórax, abdômen e extremidades inferiores. Foi realizado na Unidade de Terapia Intensiva Neonatal (UTIN), da Maternidade Escola Assis Chateaubriand (MEAC), na cidade de Fortaleza-Ceará, Brasil. A amostra foi constituída por RNPT que atenderam aos seguintes critérios de inclusão: ter peso ≤ 1.500 gramas e idade gestacional ≤ 32 semanas; permanecer na unidade por um período de sete dias; não apresentar malformações graves que afetasse a integridade da pele. Foram excluídos RNPT com estado de saúde debilitado, que impossibilitasse o término do estudo; portadores de malformação congênita, como gastrosquise, mielomeningocele ou onfalocele, e o consentimento dado pelos pais e/ou responsáveis pelos RN. Foram consideradas variáveis de desfecho: sódio, glicemia, densidade urinária, peso e perdas líquidas. Sexo e idade gestacional compuseram as variáveis principais da linha de base do experimento. As perdas líquidas foram medidas com auxílio de Tewameter aplicado sobre a pele do RNPT, por um tempo de 30 segundos. Com os dados compilados no Excel e a análise estatística com apoio do software R versão 2.12.1. O nível de significância adotado no estudo foi 5% e os dados foram apresentados em tabelas. As recomendações éticas foram seguidas durante as etapas da pesquisa. Os RNPT foram admitidos do Centro Obstétrico e os diagnósticos médicos principais foram: prematuridade, síndrome do desconforto respiratório e doença da membrana hialina. Os RNPT dos quatro grupos no total permaneceram em: incubadora de parede dupla umidificada (100%), sob ventilação mecânica (86,84 %), CPAP nasal (7,89%) e em uso de hidratação venosa por acesso central (100%). Faziam uso de antibioticoterapia e nutrição parenteral (100%), alimentação enteral (7,89%) e fototerapia (68,42%). A aplicação da membrana semipermeável, logo após o nascimento, mostrou-se eficaz no que diz respeito à manutenção do sódio, cota hídrica, densidade urinária e glicemia. As perdas transepidérmicas foram inferiores no grupo que usou a membrana semipermeável em toda a extensão do corpo, mas não foi estatisticamente diferente daquelas nas quais a membrana foi aplicada no tórax e abdômen (Grupo 3). Este grupo, por sua vez, apresentou valores glicêmicos inferiores aos dos grupos que tiveram a membrana aplicada nos membros inferiores e tórax ou abdômen (Grupos 1, 2 e 3), mas não diferente dos RNPT que a utilizaram em toda a extensão corporal (Grupo 4). Além disso, as mudanças intragrupo observadas no período de seguimento entre as seis variáveis estudadas foram similares nos quatro grupos. Desta forma, existem indícios de que o uso da membrana semipermeável aplicada no tórax e abdômen pode ter efeito similar a seu uso em todo o corpo. Todavia, deve-se considerar que o tamanho reduzido da amostra pode ter contribuído para não detecção de diferenças estatísticas, devendo-se ponderar estes resultados.Lopes, Marcos Venícios de OliveiraGurgel, Eloah de Paula Pessoa2016-03-23T15:01:34Z2016-03-23T15:01:34Z2015info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfGURGEL, E P. P. Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas. 2015. 96 f. Tese (Doutorado em Enfermagem) – Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.http://www.repositorio.ufc.br/handle/riufc/15734porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2019-02-01T17:57:25Zoai:repositorio.ufc.br:riufc/15734Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:31:10.813857Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
Effectiveness evaluation of the semipermeable membrane in the skin of preterm infants as technological resource to prevent transepidermal water loss
title Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
spellingShingle Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
Gurgel, Eloah de Paula Pessoa
Recém-Nascido
Pele
Enfermagem
title_short Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
title_full Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
title_fullStr Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
title_full_unstemmed Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
title_sort Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas
author Gurgel, Eloah de Paula Pessoa
author_facet Gurgel, Eloah de Paula Pessoa
author_role author
dc.contributor.none.fl_str_mv Lopes, Marcos Venícios de Oliveira
dc.contributor.author.fl_str_mv Gurgel, Eloah de Paula Pessoa
dc.subject.por.fl_str_mv Recém-Nascido
Pele
Enfermagem
topic Recém-Nascido
Pele
Enfermagem
description The neonatal population represents a strategic group as regards the reduction of infant mortality. Therefore, it becomes a challenge for the team assisting these patients to keep them stable with their vital functions in balance, since important changes occur during fetal life and after birth, especially in preterm infants. This study aimed to evaluate the efficacy of using the semipermeable membrane as technological resource applied in different areas of the preterm infants’ skin seeking to reduce transepidermal water loss. Seventy-two preterm infants underwent an experimental study, randomly distributed into four groups to receive the semipermeable membrane in different areas essential for application: thorax, abdomen and lower extremities. It took place at the Neonatal Intensive Care Unit (NICU) of the Maternity School Assis Chateaubriand (MEAC) in the city of Fortaleza, Ceará, Brazil. The sample consisted of preterm infants who met the following inclusion criteria: weight ≤ 1,500 grams and gestational age ≤ 32 weeks; remain in the unit for seven days; not show any severe malformations that affect skin integrity. We excluded infants with weakened health that prevented completion of the study; patients with congenital malformations, such as gastroschisis, omphalocele or myelomeningocele; and the consent given by parents and/or guardians of preterm infants. As outcome variables, we considered sodium, glucose, urine specific gravity, weight, and fluid loss. Gender and gestational age constituted the main variables of the experiment baseline. Fluid losses were measured with the aid of Tewameter applied to the skin of preterm infants, for 30 seconds. Data were compiled into Excel and statistical analysis with the software support R 2 version. 12. 1. In this study, we used a significance level of 5% and presented the data in tables. The ethical recommendations were followed during the research steps. Preterm infants were admitted to the Obstetric Center and the main medical diagnoses were prematurity, respiratory distress syndrome, and hyaline membrane disease. In total, preterm infants of the four groups were kept in humidified double walled incubators (100%), under mechanical ventilation (86.84%), nasal CPAP (7.89%), and use of intravenous hydration through central access (100%). They used antibiotics and parenteral nutrition (100%), enteral nutrition (7.89%), and phototherapy (68.42%). Applying the semipermeable membrane, soon after birth, was effective with regard to the maintenance of sodium, water quota, urine density, and glucose. Transepidermal loss was lower in the group that used the semipermeable membrane along the body extension, but it was not statistically different from those in which the membrane was applied to the thorax and abdomen (Group 3). In turn, this group presented lower blood glucose levels than the groups who had the membrane applied in the lower limbs and the thorax or abdomen (Groups 1, 2 and 3), but not different from newborns who used it along the body extension (Group 4). Furthermore, the intragroup changes observed in the following period among the six variables in study were similar in the four groups. This way, there are indications that using the semipermeable membrane applied to the thorax and abdomen may have a similar effect to its use along the body extension. Nonetheless, it should be noted that the small sample size might have contributed to failure to detect statistical differences, thus these results should be considered.
publishDate 2015
dc.date.none.fl_str_mv 2015
2016-03-23T15:01:34Z
2016-03-23T15:01:34Z
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dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.uri.fl_str_mv GURGEL, E P. P. Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas. 2015. 96 f. Tese (Doutorado em Enfermagem) – Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.
http://www.repositorio.ufc.br/handle/riufc/15734
identifier_str_mv GURGEL, E P. P. Avaliação da eficácia da membrana semipermeável na pele de recém-nascido prematuro como recurso tecnológico para prevenção de perdas de água transepidérmicas. 2015. 96 f. Tese (Doutorado em Enfermagem) – Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2015.
url http://www.repositorio.ufc.br/handle/riufc/15734
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