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Innovative air mattress for the prevention of pressure ulcers in neonates
Tino Adrian Jucker1,2, Simon Annaheim1, Elodie Morlec1
1Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, St. Gallen, Switzerland.
Insights
Innovative air mattresses significantly reduce pressure ulcer risk in newborns by lowering interface pressures. Optimal pressure distribution depends on mattress design and air-fill levels, crucial for vulnerable infants.
Area of Science:
- Neonatal intensive care
- Biomedical engineering
- Materials science
Background:
- Pressure ulcers (PUs) affect up to 28% of neonates, increasing mortality.
- Neonates' underdeveloped stratum corneum makes them susceptible to PUs.
- The head and hip regions are high-risk areas due to immobility and body proportions.
Purpose of the Study:
- To evaluate two novel air mattress designs for reducing local pressure in neonates.
- To assess the impact of different air pressure filling states on pressure distribution.
- To investigate pressure reduction in critical areas like the hip and occipital regions.
Main Methods:
- Developed two segmented air mattress prototypes (head, trunk, feet).
- Tested three air pressure filling states (0.2kPa, 0.4kPa, 0.6kPa).
- Utilized a baby doll model (51cm, 1.3-3.3kg) and compared with foam/unsupported surfaces.
Main Results:
- Prototype 2 reduced hip interface pressure by 49% at 0.2kPa.
- Prototype 1 reduced hip interface pressure by 41% at 0.2kPa.
- Air segment size and internal pressure critically influenced interface pressure.
Conclusions:
- Air mattresses offer superior pressure reduction compared to conventional surfaces.
- Effectiveness of air mattresses is contingent on their filling status.
- Segmented, tailored designs are vital for protecting vulnerable pediatric patients.
Objective:
Pressure ulcers (PUs) severely impact health outcomes in neonatal intensive care, with up to 28% prevalence and doubled mortality rates. Due to their only partially developed stratum corneum, neonates are highly susceptible to PUs because of a lack of adequate support surfaces. The occipital region of the head and hip are the main risk areas due to immobility and newborn body proportions. The main goal of the study was to investigate the impact of reduction in local pressure in these body areas by two air mattress designs and different filling states.
Method:
Two innovative air-filled mattress prototypes (prototype 1 and prototype 2), consisting of three different segments (head, trunk and feet regions), were developed to reduce local interface pressures by optimising pressure distribution, and were assessed with three air pressure filling states (0.2kPa, 0.4kPa and 0.6kPa). A baby doll was used to investigate pressure distribution and local pressure impact. It measured 51cm and the weight was modified to be 1.3kg, 2.3kg and 3.3kg, representing premature to term newborn weights, respectively. A specialised foam mattress and an unsupported surface were considered as controls.
Results:
The interface pressures at the hip region for newborn models could be reduced by up to 41% with mattress prototype 1 and 49% with prototype 2 when filled with 0.2kPa air pressure. It was found that the size and the pressure inside air segments was crucial for interface pressure.
Conclusion:
Our results demonstrated that air mattresses achieved lower interface pressures compared to conventional support surfaces, and that the benefit of the air mattresses depended on their filling status. The importance of using innovative, segmented designs that were tailored to meet the specific needs of highly vulnerable paediatric patients was demonstrated.
