Neonatal Infection & Sensory Stressors

The skin of premature neonates is not fully formed — it is approximately 40% to 60% thinner than adult skin — and not as capable of providing protection against environmental stressors.([FOOTNOTE=McNichol L, Lund C, Rosen T, Gray M. Medical adhesives and patient safety: state of the science: consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. Orthop Nurs. 2013;32(5):267-281.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Visscher M, Narendran V. The ontogeny of skin. Adv Wound Care. 2014;3:291-303.],[ANCHOR=],[LINK=]) The connection between the dermis and epidermis is fragile in neonates⁴ and they commonly develop skin and soft-tissue infections.¹ In addtion, poor skin integrity is also a major risk factor for neonatal sepsis⁵ and pain and skin injury during adhesive removal.⁴ Loss of epidermal layers during adhesive removal can compromise the structural integrity of neonatal skin, resulting in increased skin permeability to pathogens and irritans, which can lead to potential toxicity and higher risk of infection.⁴

Preterm infants are born during a time of rapid brain development that includes development of synaptic connections and establishment of cortical networks.([FOOTNOTE=Grunau RE. Neonatal pain in very preterm infants: long-term effects on brain, neurodevelopment and pain reactivity. Rambam Maimonides Med J. 2013;4(4):e0025.],[ANCHOR=],[LINK=]) These processes are affected by pain, which puts neurologically immature infants at risk for long-lasting consequences associated with neonatal pain.⁶

Preterm neonates are more sensitive to touch and pain than full-term babies.⁶ They also experience sensitization, in which earlier interventions can affect response to subsequent stimuli.⁶ For example, an infant who experiences a heel lance may respond to routine handling 30 minutes later as if it were an invasive procedure.⁶

Exposure to pain in preterm babies has been implicated in sensitization of pain pathways, as well as long-term alterations in brain structure, function, and neurodevelopment.⁶ These changes may contribute to the long-term difficulties in attention, executive functions, cognition, and behavioral problems associated with premature birth.⁶

• Ventilation - delivering synchronized breath, with both invasive and non-invasive ventilation, can have important benefits for neonates.([FOOTNOTE=Mahmoud RA, Proquitté H, Fawzy N, Bührer C, Schmalisch G. Tracheal tube airleak in clinical practice and impact on tidal volume measurement in ventilated neo¬nates. Pediatr Crit Care Med. 2011;12(2):197-202],[ANCHOR=],[LINK=])
• Patient monitoring - providing continuous SpO₂, pulse rate, and respiration rate monitoring, so clinicians may detect respiratory complications earlier and intervene sooner.([FOOTNOTE=Joint Commission Sentinel Event Alert: Issue #49, pp1-4, August 8, 2012. (Available at www.jointcommission.org).],[ANCHOR=],[LINK=])^,([FOOTNOTE=ASA Standards for Basic Anesthetic Monitoring, Committee of Origin: Standards and Practice Parameters (Approved by the ASA House of Delegates on October 21, 1986, and last amended on October 20, 2010 with an effective date of July 1, 2011, excerpt from section 3.2.4.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Essential Monitoring Strategies to Detect Clinically Significant Drug-Induced Respira¬tory Depression in the Postoperative Period. Prepared by Stoelting, R. and Overdyk, F. http://www.apsf.org/announcements.php?id=7.],[ANCHOR=],[LINK=])
• Procedural stress - reducing any associated pain, discomfort, or risk of infection may help.

Discover below which respiratory & monitoring products from Medtronic can help reducing stress of neonatal patients.