Water loss from the skin of term and preterm babies.

Rutter, N; Hull, D

doi:10.1136/adc.54.11.858

Cited by 173 publications

(90 citation statements)

References 16 publications

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“…Stratum corneum lipids also provide the bamer to absorption of epicutaneously applied compounds, and the mature barrier is particularly impermeable to water-soluble compounds. In preterm infants, both TEWL and percutaneous absorption of xenobiotics are increased (3)(4)(5)(6)(7)(8). Although we found no bamer to TEWL until late gestation (20 d) in the fetal rat, it is possible that other measures of permeability bamer function, such as percutaneous absorption of water-soluble materials, may demonstrate some bamer function at earlier stages in development (56,57).…”

Section: Discussioncontrasting

confidence: 40%

“…In summary, these studies demonstrate that in the rat, as in man (3)(4)(5)(6)(7)(8) and swine (56), development of a competent epidermal bamer to water loss occurs late in gestation. Establishment of a competent bamer in the rat was correlated with 1 ) organization of stratum corneum lipids into basic lamellar unit structures; 2) increasing stratum corneum thickness; 3) increasing stratum corneum lipid content; and 4) enrichment of stratum corneum lipid with cholesterol and nonpolar ceramides.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas pups of 19 The primary function of mammalian epidermis during terrestrial life is the generation and maintenance of a competent bamer to TEWL. Although the term human neonate is born with a competent barrier (1-3), preterm infants (<33 wk EGA) have an impaired bamer to both water loss and the percutaneous absorption of water-soluble compounds; the extent of bamer dysfunction is proportional to the degree of prematurity (3)(4)(5)(6)(7)(8). TEWL accounts for 75% of the insensible water loss in the preterm infant and may lead to dehydration and thermoinstability (9-1 5).…”

mentioning

confidence: 99%

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Ontogeny of the Epidermal Barrier to Water Loss in the Rat: Correlation of Function with Stratum Corneum Structure and Lipid Content

et al. 1992

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ABSTRACT. The mammalian epidermal permeability barrier is provided by highly hydrophobic lipids forming multiple membrane bilayers within the extracellular domains of the outer, cornified cell layers. To characterize the critical events associated with barrier maturation, we correlated the emergence of a competent barrier to transepidermal water loss with development of the lamellar body secretory system, the organization of stratum corneum membrane bilayers, and the lipid composition of these membranes in the perinatal rat. The primary function of mammalian epidermis during terrestrial life is the generation and maintenance of a competent bamer

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Ontogeny of the Epidermal Barrier to Water Loss in the Rat: Correlation of Function with Stratum Corneum Structure and Lipid Content

et al. 1992

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“…Severe burns abrogate these barrier properties and lead to an increased risk of infection and difficulties with maintaining fluid and electrolyte balance. Similarly, in premature infants, the skin is not fully developed and barrier function is impaired; therefore, they also have great difficulties in maintaining fluid and electrolyte balance (2,3). More subtle functional abnormalities in skin barrier function occur in neonates, in the elderly, and in association with several cutaneous diseases, including psoriasis and atopic dermatitis (4)(5)(6).…”

Section: Jlr: Dr Feingold What Is the Key Function Of The Skin?mentioning

confidence: 99%

Thematic review series: Skin Lipids. The role of epidermal lipids in cutaneous permeability barrier homeostasis

Feingold

2007

Journal of Lipid Research

366

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The permeability barrier is required for terrestrial life and is localized to the stratum corneum, where extracellular lipid membranes inhibit water movement. The lipids that constitute the extracellular matrix have a unique composition and are 50% ceramides, 25% cholesterol, and 15% free fatty acids. Essential fatty acid deficiency results in abnormalities in stratum corneum structure function. The lipids are delivered to the extracellular space by the secretion of lamellar bodies, which contain phospholipids, glucosylceramides, sphingomyelin, cholesterol, and enzymes. In the extracellular space, the lamellar body lipids are metabolized by enzymes to the lipids that form the lamellar membranes. The lipids contained in the lamellar bodies are derived from both epidermal lipid synthesis and extracutaneous sources. Inhibition of cholesterol, fatty acid, ceramide, or glucosylceramide synthesis adversely affects lamellar body formation, thereby impairing barrier homeostasis. Studies have further shown that the elongation and desaturation of fatty acids is also required for barrier homeostasis. The mechanisms that mediate the uptake of extracutaneous lipids by the epidermis are unknown, but keratinocytes express LDL and scavenger receptor class B type 1, fatty acid transport proteins, and CD36. Topical application of physiologic lipids can improve permeability barrier homeostasis and has been useful in the treatment of cutaneous disorders.-Feingold, K. R. The role of epidermal lipids in cutaneous permeability barrier homeostasis. J. Lipid Res.

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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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Water loss from the skin of term and preterm babies.

Cited by 173 publications

References 16 publications

Ontogeny of the Epidermal Barrier to Water Loss in the Rat: Correlation of Function with Stratum Corneum Structure and Lipid Content

Ontogeny of the Epidermal Barrier to Water Loss in the Rat: Correlation of Function with Stratum Corneum Structure and Lipid Content

Thematic review series: Skin Lipids. The role of epidermal lipids in cutaneous permeability barrier homeostasis

Neonatal hypothermia in low resource settings: a review

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