O uso da membrana semipermeável como proteção da pele do recém-nascido prematuro

• Autor(a) principal: Gurgel, Eloah de Paula Pessoa
• Data de Publicação: 2008
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/1775
• topic: Recém-Nascido; Doenças do Prematuro

Care delivery to newborn infants at the intensive care unit demands theoretical-practical knowledge on skin care, as different procedures lead to the breaking of this protective barrier and can cause severe injuries. Moreover, skin maturity needs to be stimulated in premature infants. Thus, this study aimed to examine the efficiency of the semipermeable membrane as a technological resource for use on premature newborn infants’ (PMNI) skin to reduce transepidermal water loss and electrolyte disorders. This experimental study is a randomized clinical trial and was carried out at the Neonatal Intensive Care Unit (NICU) of the Teaching Maternity Assis Chateaubriand – MEAC in Fortaleza-Ceará, Brazil, between March and August 2008. The sample included 42 PMNI who complied with the following inclusion criteria: birth weight ≤ 1,500 grams and gestational age ≤ 32 weeks; permanence of at least seven days at the unit; no severe malformations that affected skin integrity; and the consent of parents and/or persons responsible for the infants. The study variables were weight, water balance, urine density, glucose control, sodium dosage and daily water quota. The data were compiled in Excel and statistical analysis was performed in SPSS. A five-percent significance level was adopted and data were presented in tables and charts. All ethical recommendations were followed during all research phases. All PMNI were admitted from the Obstetric Center and the main medical diagnoses were: prematurity, respiratory discomfort syndrome and hyaline membrane disease. The PMNI were accommodated in a double wall incubator (100%), received mechanical ventilation (95,2%) and (100%), used intravenous hydration via central access (81%) and (100%) , commonly antibiotics therapy, parenteral nutrition (71,4%) and (95,2%), enteral feeding (81%) and (61,9%) , phototherapy (71,4%) and (66,7%). As to birth weight, a daily weight loss of 20g occurred in the intervention group (IG), against 18g in the control group (CG). What diuresis is concerned, data showed a statistically significant regression. As for glucose, 4,4 times more episodes of hyperglycemia were evidenced in CG than in IG. The results for the water quota showed a regression of 7,220 for IG, against 6,094 for CG. What the urine density results is concerned, a slight decrease of only 0,777 was found for IG, against a daily increase of 22.892 for CG, that is, the latter presented higher urine density than IC during the seven days. As to sodium, regression for IG was around 0,603, against 1,835 for CG. Infants in CG had 3.0 times higher chances of hypernatremia in the study period. It was found that the application of the semipermeable membrane, the PMNI for IG was associated with decreased sodium levels and daily fluid demands during the first week of life in PMNI, who also presented less episodes of hyperglycemia and whose urine density was maintained within normal standards in comparison with PMNI in CG. The semipermeable membrane is actually an effective therapeutic resource to minimize transepidermal water losses in PMNI.