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Transepidermal water loss in the infant surgical patient
Insights
Reducing evaporative water loss in newborn surgical patients is crucial for maintaining water balance and preventing heat loss. Covering infants with impermeable plastic significantly lowers water loss, with plastic bags offering the greatest reduction.
Area of Science:
- Neonatal Surgery
- Pediatric Critical Care
- Thermoregulation in Infants
Background:
- Evaporative water loss (EWL) from infant skin is a significant factor in neonatal surgical patients.
- EWL contributes to both water balance disturbances and heat loss in this vulnerable population.
Purpose of the Study:
- To investigate methods for reducing evaporative water loss in newborn surgical patients.
- To assess the impact of different covering materials on infant transepithelial water loss.
Main Methods:
- Studied 15 infant surgical patients under five clinical conditions.
- Evaluated conditions including exposed infants, cloth drapes, plastic drapes, plastic sheeting (top and bottom), and plastic bags.
Main Results:
- Impermeable plastic sheeting significantly reduced evaporative water loss in infant surgical patients.
- Increased relative humidity around the infant, due to trapped water vapor, was the mechanism for reduced EWL.
- Utilizing a plastic bag provided the most substantial reduction in transepithelial water loss.
Conclusions:
- Impermeable plastic coverings are effective in minimizing evaporative water loss in newborn surgical patients.
- Plastic sheeting and bags can be utilized to improve water balance and thermoregulation.
- Further research into optimal methods for reducing EWL in this population is warranted.
Abstract:
Evaporative water loss from skin of the newborn surgical patient is a critical factor in overall water balance and an important source of heat loss. We studied 15 infant surgical patients under the following clinical conditions: (1) exposed babies; (2) infants covered by cloth drapes and lying on a cloth blanket; (3) infants covered by a plastic drape and lying on a cloth blanket; (4) babies lying on a plastic sheet and covered by a plastic sheet; and (5) infants placed in a plastic bag. This study demonstrated that evaporative water loss of the infant surgical patient can be significantly reduced by placing impermeable plastic sheets over and under the baby. This allowed water vapor to accumulate about the baby, increasing the relative humidity and reducing the evaporative water loss. An even further reduction in transepithelial water loss was accomplished by utilizing a plastic bag.