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Interface pressure comparison of healthy premature infants with various neonatal bed surfaces
Carol Turnage-Carrier1, Kathleen M McLane, Mary Ann Gregurich
1Texas Children's Hospital Newborn Center, Houston, TX 77030, USA. cacarrie@texaschildrenshospital.org
Insights
Interface pressure varies significantly between neonatal bed surfaces. Foam overlays offer the lowest pressure, crucial for preventing tissue damage and head molding in premature infants.
Area of Science:
- Neonatal care
- Biomedical engineering
- Materials science
Background:
- Premature infants are at high risk for tissue compromise and positional head molding.
- Special care nurseries utilize various support surfaces, but their impact on interface pressure is not fully understood.
Purpose of the Study:
- To quantify interface pressure between the occiput of premature infants and five distinct neonatal bed surfaces.
- To identify differences in pressure distribution across various support surfaces.
Main Methods:
- A quasi-experimental design was employed with 13 healthy premature infants.
- Interface pressures were measured using the Mini-Texas Interface Pressure Evaluator (Mini-TIPE).
- Five bed surfaces were tested: standard crib mattress (with/without foam), gel donut, gel mattress, and water pillow, with randomized order.
Main Results:
- Significant differences in mean interface pressures were found among the five bed surfaces (F(4,46) = 33.267, P < .001).
- The standard crib mattress exhibited the highest interface pressure (>100 mm Hg).
- Foam overlay resulted in the lowest interface pressure, with significant differences compared to standard and other surfaces.
Conclusions:
- Interface pressure is a critical factor in selecting support surfaces for premature infants to mitigate tissue compromise and head molding.
- Substantial variations exist in interface pressures generated by different neonatal bed surfaces.
- Further comparative studies are needed to guide the selection of optimal support surfaces for neonates requiring prolonged intensive care.
Purpose:
The aim of this study was to determine interface pressure between the occiput of healthy premature infants and 5 different bed surfaces used in special care nurseries.
Subjects:
Thirteen healthy premature infants comprised the convenience sample enrolled 1 to 3 weeks prior to discharge.
Design:
A quasi-experimental design was used with the dependent variable being the interface pressures obtained under the occiput and the independent variables as the bed surfaces.
Methods:
Order of bed surfaces was randomized and standardization of the infant positioning and measuring procedure maintained. Measurements were made between the infant's occiput and the bed surface and interface pressures recorded in millimeters of mercury. The 5 bed surfaces were standard crib mattress with or without foam, gel donut, gel mattress, and water pillow.
Measures:
Interface pressure measurements were obtained using the Mini-Texas Interface Pressure Evaluator (Mini-TIPE, Tee-Kay Applied Technology, Inc, Stafford, Texas).
Results:
A 1-way blocked analysis of variance was conducted to evaluate the relationship between the mattress surfaces and the interface pressure measurements. A significant difference in the mean of the interface pressures among the 5 mattress bed surfaces was determined, F(4,46) = 33.267, P < .001, with the lowest being the foam overlay. The standard crib mattress had the highest interface pressure that exceeded 100 mm Hg. Post hoc comparisons showed a significant difference between the standard crib mattress with and without foam and the other surfaces.
Conclusions:
Interface pressure is an important consideration when choosing a support surface for premature infants susceptible to tissue compromise and head molding. Variations in interface pressures between neonatal bed surfaces are apparent. Comparison studies of interface pressures using these and other neonatal bed surfaces will be valuable in determining appropriate products for both premature and neonatal populations with lengthy intensive care stays.
