Valentina Cardiello1, Enrico Zecca2, Mirta Corsello1, Teresa Pianini1, Francesca Serrao1, Simonetta Costa1, Francesco Cota1. 1. Neonatal Intesive Care Unit (NICU), "A. Gemelli" University Hospital, Università Cattolica del Sacro Cuore, l.go Agostino Gemelli 8, 00168 Rome, Italy. 2. Neonatal Intesive Care Unit (NICU), "A. Gemelli" University Hospital, Università Cattolica del Sacro Cuore, l.go Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: enrizecca@libero.it.
Abstract
BACKGROUND: Hypernatremic dehydration is a complication of preterm infants with reportedly high morbility. In preterm infants, this happens due to a combination of low fluid intake, transepidermal water loss (TEWL), and immaturity of kidney function. Semipermeable membranes are self-adhesive membranes that can be applied as an artificial skin to reduce TEWL. AIMS: To test the hypothesis that early application of a semipermeable membrane (Tegaderm™) in preterm infants ≤30 weeks could result in a significant reduction of hypernatremia (serum Na > 145 mEq/l) during the first 15 days of life. STUDY DESIGN: Randomized controlled trial (UMIN000010515). SUBJECTS:164 consecutive newborns with gestational age ≤ 30 weeks, absence of congenital skin defects, and duration of admission ≥ 15 days. Patients were randomized to receive semipermeable membrane (n = 82) or no membrane (n = 82) for the first 15 days of life. OUTCOME MEASURES: The primary endpoint of the study was the incidence reduction of hypernatremia (Na > 145 mEq/l). Secondary endpoints included: postnatal weight loss (WL) and time to birth weight (BW) recovery. RESULTS:Incidence of hypernatremia in the control and semipermeable membrane group was 59.7% and 41.6%, respectively (p = 0.030). Postnatal WL was larger in the control group (13.9 ± 5.6% vs 11.1 ± 3.4%, p = 0.005) and occurred later than the semipermeable membrane group (5.4 ± 2.3 vs 4.5 ± 1.4 days, p = 0.005). Time to BW recovery was also longer for control group (13.5 ± 4.3 vs 11.9 ± 3.2 days, p = 0.016). CONCLUSIONS: Early application of skin semipermeable membrane to ≤30 week preterm is associated with decreased incidence of hypernatremia, decreased %WL, and earlier BW recovery. No complications were observed with membrane application.
RCT Entities:
BACKGROUND:Hypernatremic dehydration is a complication of preterm infants with reportedly high morbility. In preterm infants, this happens due to a combination of low fluid intake, transepidermal water loss (TEWL), and immaturity of kidney function. Semipermeable membranes are self-adhesive membranes that can be applied as an artificial skin to reduce TEWL. AIMS: To test the hypothesis that early application of a semipermeable membrane (Tegaderm™) in preterm infants ≤30 weeks could result in a significant reduction of hypernatremia (serum Na > 145 mEq/l) during the first 15 days of life. STUDY DESIGN: Randomized controlled trial (UMIN000010515). SUBJECTS: 164 consecutive newborns with gestational age ≤ 30 weeks, absence of congenital skin defects, and duration of admission ≥ 15 days. Patients were randomized to receive semipermeable membrane (n = 82) or no membrane (n = 82) for the first 15 days of life. OUTCOME MEASURES: The primary endpoint of the study was the incidence reduction of hypernatremia (Na > 145 mEq/l). Secondary endpoints included: postnatal weight loss (WL) and time to birth weight (BW) recovery. RESULTS: Incidence of hypernatremia in the control and semipermeable membrane group was 59.7% and 41.6%, respectively (p = 0.030). Postnatal WL was larger in the control group (13.9 ± 5.6% vs 11.1 ± 3.4%, p = 0.005) and occurred later than the semipermeable membrane group (5.4 ± 2.3 vs 4.5 ± 1.4 days, p = 0.005). Time to BW recovery was also longer for control group (13.5 ± 4.3 vs 11.9 ± 3.2 days, p = 0.016). CONCLUSIONS: Early application of skin semipermeable membrane to ≤30 week preterm is associated with decreased incidence of hypernatremia, decreased %WL, and earlier BW recovery. No complications were observed with membrane application.