Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between them.Met...Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between them.Methods A web-based survey was conducted between February 2019 and August 2021.Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes.The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions.Results Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were received.Diaper dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common injuries.Following a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were observed.Conclusions Skin injuries were common in extremely preterm infants.Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries.Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.展开更多
Background：Compared with full-term infants, very preterm infants are more vulnerable to injury and long-term disability and are at high risk of death. The predictive value of ultrasound and imaging on the neurodevelo...Background：Compared with full-term infants, very preterm infants are more vulnerable to injury and long-term disability and are at high risk of death. The predictive value of ultrasound and imaging on the neurodevelopment is one of the hot topics. This study aimed to investigate the relationship between cranial ultrasound （cUS） variables and neurodevelopmental outcomes of very preterm infants.Methods：Totally 129 very preterm infants （gestational age ≤28 weeks） in neonatal intensive care unit of Hunan Children’s Hospital between January 2012 and November 2014 were included in this retrospective study. Serial cUS （weekly before discharge and monthly after discharge） was performed on the infants until 6 months or older. Magnetic resonance imaging （MRI） was performed on the infants at approximately the term-equivalent age. The mental developmental index （MDI） and psychomotor developmental index （PDI） were followed up until the infants were 24 months or older. The relationship between brain injury and MDI/PDI scores was analyzed.Results：The consistency rate between cUS and MRI was 88%. At the first cUS, germinal matrix hemorrhage （GMH） Grades 3 and 4, hospitalization duration, and weight are significantly correlated with MDI/PDI and prognosis （MDI： odds ratio [OR] = 8.415, 0.982, and 0.042, P = 0.016, 0.000, and 0.004; PDI： OR = 7.149, 0.978, and 0.012, P = 0.025, 0.000, and 0.000, respectively）. At the last cUS, gestational age, extensive cystic periventricular leukomalacia （c-PVL）, and moderate and severe hydrocephaly are significantly correlated with MDI （OR = 0.292, 60.220, and 170.375, P = 0.004, 0.003, and 0.000, respectively）. Extensive c-PVL and moderate and severe hydrocephaly are significantly correlated with PDI （OR = 76.861 and 116.746, P = 0.003 and 0.000, respectively）.Conclusions：Very premature infants with GMH Grades 3 and 4, short hospitalization duration, and low weight have low survival rates and poorly developed brain nerves. Cerebral palsy can result from severe cerebral hemorrhage, moderate and severe hydrocephaly, and extensive c-PVL. The sustained, inhomogeneous echogenicity of white matter may suggest subtle brain injury.展开更多
文摘Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between them.Methods A web-based survey was conducted between February 2019 and August 2021.Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes.The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions.Results Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were received.Diaper dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common injuries.Following a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were observed.Conclusions Skin injuries were common in extremely preterm infants.Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries.Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.
文摘Background：Compared with full-term infants, very preterm infants are more vulnerable to injury and long-term disability and are at high risk of death. The predictive value of ultrasound and imaging on the neurodevelopment is one of the hot topics. This study aimed to investigate the relationship between cranial ultrasound （cUS） variables and neurodevelopmental outcomes of very preterm infants.Methods：Totally 129 very preterm infants （gestational age ≤28 weeks） in neonatal intensive care unit of Hunan Children’s Hospital between January 2012 and November 2014 were included in this retrospective study. Serial cUS （weekly before discharge and monthly after discharge） was performed on the infants until 6 months or older. Magnetic resonance imaging （MRI） was performed on the infants at approximately the term-equivalent age. The mental developmental index （MDI） and psychomotor developmental index （PDI） were followed up until the infants were 24 months or older. The relationship between brain injury and MDI/PDI scores was analyzed.Results：The consistency rate between cUS and MRI was 88%. At the first cUS, germinal matrix hemorrhage （GMH） Grades 3 and 4, hospitalization duration, and weight are significantly correlated with MDI/PDI and prognosis （MDI： odds ratio [OR] = 8.415, 0.982, and 0.042, P = 0.016, 0.000, and 0.004; PDI： OR = 7.149, 0.978, and 0.012, P = 0.025, 0.000, and 0.000, respectively）. At the last cUS, gestational age, extensive cystic periventricular leukomalacia （c-PVL）, and moderate and severe hydrocephaly are significantly correlated with MDI （OR = 0.292, 60.220, and 170.375, P = 0.004, 0.003, and 0.000, respectively）. Extensive c-PVL and moderate and severe hydrocephaly are significantly correlated with PDI （OR = 76.861 and 116.746, P = 0.003 and 0.000, respectively）.Conclusions：Very premature infants with GMH Grades 3 and 4, short hospitalization duration, and low weight have low survival rates and poorly developed brain nerves. Cerebral palsy can result from severe cerebral hemorrhage, moderate and severe hydrocephaly, and extensive c-PVL. The sustained, inhomogeneous echogenicity of white matter may suggest subtle brain injury.
