TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS: IV. <i>Small for Gestational Age Infants</i>

Hammarlund, K; Sedin, Gunnar

doi:10.1111/j.1651-2227.1980.tb07096.x

Cited by 108 publications

(156 citation statements)

References 17 publications

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“…Preterm babies have consistently higher insensible heat losses 35,36 compared with term babies as a result of high water loss from the skin. 37,38 These losses are particularly high in babies <33 weeks gestational age during the first few days of life due to their thin, poorly keratinized stratum corneum, which offers low resistance to the diffusion of water. 39 Asphyxiated babies are also at increased risk of profound drop in body temperature immediately after birth.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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“…Significant progress was then possible due to the development of "evaporimeters" that directly measured water vapour at the skin surface, and numerous investigations with this apparatus then confirmed previous findings [22][23]. TEWL (evaporimeter) was inversely and exponentially related to GA for both low and normal weight infants during the first 4 weeks after birth [24].…”

Section: The Development Of Skin Barrier Functionmentioning

confidence: 83%

“…It was suggested later that, while functional maturation of the SC starts around the 24 week of gestation, a well-defined SC is not visible before 34 wk GA. Indeed, SC formation has been observed at 22 wk GA in the epidermis of the head/scalp and in palmar/plantar skin and, at 25 wk, over the rest of the body [12]. According to some, a functional skin barrier appears regionally, with the inter-follicular barrier forming at 20-21 wk GA on the head and at 23-24 wk GA on the abdomen.…”

Section: The Development Of Skin Barrier Functionmentioning

confidence: 99%

Effective use of transdermal drug delivery in children

Delgado‐Charro

Guy

2014

Advanced Drug Delivery Reviews

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“…[1][2][3][4] Thus, large transepidermal water losses (TEWL) occur early in life. 5,6 This large evaporative loss of free water leads to marked fluid losses 3 and results in significant morbidity secondary to clinical dehydration.…”

Section: Introductionmentioning

confidence: 99%

Improved Outcome of Extremely Low Birth Weight Infants with Tegaderm® Application to Skin

2005

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Significant fluid and electrolyte disturbances occur in extremely low birth weight (ELBW) infants in the first few days of life. We investigated the effect of semipermeable polyurethane membrane (Tegaderm s ) applied to the skin shortly after birth on fluid and electrolyte status and the clinical outcome in these infants. STUDY DESIGN:We reviewed charts of ELBW infants (BW<1.0 kg) born during 24 months prior to Tegaderm s application and 19 months after starting Tegaderm s . Data were collected daily from the first week of life and additional clinical morbidities were compared. RESULTS:A total of 39 infants from pre-Tegaderm s period (NOTEG) (mean±SD, BW 756±158 g, GA 26.1±1.9 weeks) were compared to 30 infants with extensive Tegaderm s application to chest, abdomen and extremities (TEG) (BW 802±160 g, GA 26.3±1.8 weeks). The groups were similar in maternal demographics as well as postnatal surfactant use. Throughout the first week of life, serum Na levels, daily fluid intake and daily weight loss were significantly higher in the NOTEG infants (all Pr0.04) while BUN/Serum creatinine levels were similar. Hypernatremia (Na>150 mEq/ l) developed in 51% of NOTEG infants compared to 17% of TEG (P ¼ 0.0005) and daily fluid intake Z170 ml/kg/day was required in 54 vs 13% (P ¼ 0.0008), respectively. The mean time to regain BW was significantly longer in NOTEG vs TEG infants, 20.7±7.4 vs 15.8±6.3 days, respectively (P<0.02). There were no statistical significant differences among the groups in incidence of IVH, NEC, PDA or nosocomial sepsis; however, respiratory outcome was better in TEG infants. They had significantly less BPD (58% in NOTEG vs 22% TEG (P ¼ 0.01)) and fewer infants in the TEG group required supplemental oxygen at discharge (58% vs 22% (P ¼ 0.01)). Survival was significantly higher in TEG 90% vs 64% in NOTEG infants (P ¼ 0.02). CONCLUSIONS:Semipermeable polyurethane membrane application to skin of ELBW infants shortly after birth decreased postnatal fluid and electrolyte disturbances and significantly improved their outcome by reducing severity of lung disease and decreasing mortality.

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TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS: IV. Small for Gestational Age Infants

Cited by 108 publications

References 17 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Effective use of transdermal drug delivery in children

Improved Outcome of Extremely Low Birth Weight Infants with Tegaderm® Application to Skin

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