Skin Abnormalities Clinical Trial
— PrepicareOfficial title:
Assessment of an Innovative Air Mattress On Critically Ill Infants
The permanent bedding of critically ill neonates and infants in the pediatric intensive care unit (PICU) for an extended amount of time can result in the development of pressure injuries (PI). PIs can form due to high and permanent local interface pressure induced by contact with bed surfaces or other medical devices. The currently used state-of-the-art support systems consist of conventional foam mattresses. In this study, the investigators explore the effect of a newly developed air mattress with regard to contact are and reduction in the average interface pressure in infants assigned to the pediatric intensive care unit of the childrens hospital in Zurich.
Status | Recruiting |
Enrollment | 26 |
Est. completion date | July 2024 |
Est. primary completion date | July 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 10 Days to 6 Months |
Eligibility | Inclusion Criteria: - Informed consent signed by the legal guardian - Admitted to the pediatric intensive care unit (PICU) - Age: late preterm (>34 gestational age) up to 6 months - Admission at least 24 hours to PICU prior to intervention - Presence/availability of at least one parent/legal guardian Exclusion Criteria: - Life threatening condition - Patients who cannot be positioned in supine position - Skin injury at body area in contact with support surface - Patients with congenital skin disorders - Patients with omphalocele or gastroschisis - Newborns with peripartum asphyxia and hypothermia therapy - Language communication difficulties with the legal guardians - Surgical patients on the day of surgery - birth weight <1250g |
Country | Name | City | State |
---|---|---|---|
Switzerland | University Children's Hospital Zurich | Zurich |
Lead Sponsor | Collaborator |
---|---|
Simon Annaheim | University Children's Hospital, Zurich |
Switzerland,
Jevon P, Gallier H. How to measure capillary refill time in patients who are acutely ill. Nursing Times [online]. 2020; 116(8): 29-30.
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Interface pressure resulting from the exposure of patients to the supportive structures as measured by a pressure sensitive mat (xsensor, LX100:100.160.05, XSENSOR Technology Corporation, Calgary, Canada). | Quantification of interface pressure between the patient and the mattress surfaces with emphasis on data of highest pressures (median for top 25% of pressure data observed; 4th quartile of pressure data). | baseline | |
Primary | Interface pressure resulting from the exposure of patients to the supportive structures as measured by a pressure sensitive mat (xsensor, LX100:100.160.05, XSENSOR Technology Corporation, Calgary, Canada). | Quantification of interface pressure between the patient and the mattress surfaces with emphasis on data of highest pressures (median for top 25% of pressure data observed; 4th quartile of pressure data). | after 60 minutes of exposure to the mattress | |
Secondary | Contact area resulting from the exposure of patients to the supportive structures as detected by a pressure sensitive mat (xsensor, LX100:100.160.05, XSENSOR Technology Corporation, Calgary, Canada) | Quantification of contact are between the patient and the mattress surface. | baseline | |
Secondary | Contact area resulting from the exposure of patients to the supportive structures as detected by a pressure sensitive mat (xsensor, LX100:100.160.05, XSENSOR Technology Corporation, Calgary, Canada) | Quantification of contact are between the patient and the mattress surfaces. | after 60 minutes of exposure to the mattress | |
Secondary | Difference in stress assessment by means of heart rate | Measurement of heart rate obtained from clinical routine patient surveillance. | baseline | |
Secondary | Stress assessment by means of heart rate | Measurement of heart rate obtained from clinical routine patient surveillance. | after 60 minutes of exposure to the mattress | |
Secondary | Stress assessment by means of respiratory rate | Measurement of respiratory rate obtained from clinical routine patient surveillance. | baseline | |
Secondary | Stress assessment by means of respiratory rate | Measurement of respiratory rate obtained from clinical routine patient surveillance. | after 60 minutes of exposure to the mattress | |
Secondary | Stress assessment by means of blood pressure (mean arterial pressure) | Measurement of blood pressure obtained from clinical routine patient surveillance. | baseline | |
Secondary | Stress assessment by means of blood pressure (mean arterial pressure) | Measurement of blood pressure obtained from clinical routine patient surveillance. | after 60 minutes of exposure to the mattress | |
Secondary | Stress assessment by means of blood oxygen saturation | Measurement of blood oxygen saturation obtained from clinical routine patient surveillance. | baseline | |
Secondary | Stress assessment by means of blood oxygen saturation | Measurement of blood oxygen saturation obtained from clinical routine patient surveillance. | after 60 minutes of exposure to the mattress | |
Secondary | Stress assessment by means of body temperature | Measurement of body temperature obtained from clinical routine patient surveillance. | baseline | |
Secondary | Stress assessment by means of body temperature | Measurement of body temperature obtained from clinical routine patient surveillance. | after 60 minutes of exposure to the mattress | |
Secondary | Comfort assessment by means of a visual analogue scale | Quantification of comfort level ranging from 0 [very uncomfortable] to 10 [very comfortable]. | baseline | |
Secondary | Comfort assessment by means of a visual analogue scale | Quantification of comfort level ranging from 0 [very uncomfortable] to 10 [very comfortable]. | after 60 minutes of exposure to the mattress | |
Secondary | Stress assessment by means of a visual analogue scale | Quantification of stress level ranging from 0 [totally relaxed] to 10 [very stressed]. | baseline | |
Secondary | Stress assessment by means of a visual analogue scale | Quantification of stress level ranging from 0 [totally relaxed] to 10 [very stressed]. | after 60 minutes of exposure to the mattress | |
Secondary | Pain assessment by means of the questionnaire "Bern pain score for newborns - Revised (BSN-R)" | Assessment of pain indicators (crying, facial expression, body tension, heart rate) ranging from 0 points (no pain indication) to 3 points (high pain indication). Total values >5 points for premature babies and >3 points for term babies is indicative for pain. | baseline | |
Secondary | Pain assessment by means of the questionnaire "Bern pain score for newborns - Revised (BSN-R)" | Assessment of pain indicators (crying, facial expression, body tension, heart rate) ranging from 0 points (no pain indication) to 3 points (high pain indication). Total values >5 points for premature babies and >3 points for term babies is indicative for pain. | after 60 minutes of exposure to the mattress | |
Secondary | Unrest assessment by means of the Richmond Agitation-Sedation Scale (RASS) questionnaire | Values range from -1 (sleepy) to 0 (attentive and calm) to +4 (belligerent). | baseline | |
Secondary | Unrest assessment by means of the Richmond Agitation-Sedation Scale (RASS) questionnaire | Values range from -1 (sleepy) to 0 (attentive and calm) to +4 (belligerent). | after 60 minutes of exposure to the mattress | |
Secondary | Skin perfusion assessment by means of capillary refill time | Assessment of the capillary refill time according to Jevon and Gallier (2020). | baseline | |
Secondary | Skin perfusion assessment by means of capillary refill time | Assessment of the capillary refill time according to Jevon and Gallier (2020). | after 60 minutes of exposure to the mattress | |
Secondary | Skin assessment according to standard clinical procedure | Identification and localisation (nose, mouth, occipital, face, ear, back, leg, foot, heel, others) of skin irregularities and evaluation of severity of irregularity (redness, partial injury of skin layers, all skin layers affected, complete tissue loss) according to clinical routine | baseline | |
Secondary | Skin assessment by means of questionnaire | Identification and localisation (nose, mouth, occipital, face, ear, back, leg, foot, heel, others) of skin irregularities and evaluation of severity of irregularity (redness, partial injury of skin layers, all skin layers affected, complete tissue loss) according to clinical routine | after 60 minutes of exposure to the mattress | |
Secondary | Delirium assessment by means of the Cornell Assessment of Pediatric Delirium score (CAPD) | Assessment of delirium indicators (eye contact, purposeful actions, awareness of surroundings, communication of needs, restlessness, refusal to be comforted, hypoactivity, response time) ranging from 0 points (not indicative for delirium) to 4 points (highly indicative for delirium). A delirium state is considered from a total value of >8 points. | baseline | |
Secondary | Delirium assessment by means of the Cornell Assessment of Pediatric Delirium score (CAPD) | Assessment of delirium indicators (eye contact, purposeful actions, awareness of surroundings, communication of needs, restlessness, refusal to be comforted, hypoactivity, response time) ranging from 0 points (not indicative for delirium) to 4 points (highly indicative for delirium). A delirium state is considered from a total value of >8 points. | after 60 minutes of exposure to the mattress | |
Secondary | Withdrawal assessment by means of the Sophia Observation Withdrawal Symptoms scale (SOS) | Assessment of withdrawal indicators (autonomic dysfunction [4 aspects], overstimulation of the central nervous system [9 aspects], dysfunction of the gastrointestinal tract [2 aspects] ranging from 0 points (not detectable) to 1 point (detectable). A withdrawal state is considered from a total value of >3 points. | baseline | |
Secondary | Withdrawal assessment by means of the Sophia Observation Withdrawal Symptoms scale (SOS) | Assessment of withdrawal indicators (autonomic dysfunction [4 aspects], overstimulation of the central nervous system [9 aspects], dysfunction of the gastrointestinal tract [2 aspects] ranging from 0 points (not detectable) to 1 point (detectable). A withdrawal state is considered from a total value of >3 points. | after 60 minutes of exposure to the mattress |
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