Iatrogenic Skin Disorders and Related Factors in Newborn Infants

• Published in: Pediatric dermatology 2016-09, Vol.33 (5), p.543-548
• Main Authors: Csoma, Zsanett Renáta, Meszes, Angéla, Ábrahám, Rita, Kemény, Lajos, Tálosi, Gyula, Doró, Péter
• Format: Article
• Language: English
• Subjects: Birth Weight; Chi-Square Distribution; Cohort Studies; Critical Care - methods; Cross-Sectional Studies; Disease Management; Female; Gestational Age; Humans; Iatrogenic Disease - epidemiology; Incidence; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Pregnancy; Prospective Studies; Risk Assessment; Skin Diseases - pathology; Skin Diseases - therapy; Treatment Outcome
• ISSN: 0736-8046; 1525-1470
• DOI: 10.1111/pde.12960

Background/Objectives Recent technological advances and diagnostic and therapeutic innovations have resulted in an impressive improvement in the survival of newborn infants requiring intensive care. Consequently, with the use of modern invasive diagnostic and therapeutic procedures, the incidence of iatrogenic events has also increased. The aim of this study was to assess various iatrogenic complications in neonates requiring intensive care and determine possible contributing factors to the injuries. Methods Our prospective cross‐sectional cohort survey was conducted in a central regional level III neonatal intensive care unit (NICU). Correlations between intensive therapeutic interventions, complications, factors influencing attendance and prognosis, and the prevalence of iatrogenic skin injuries (ISIs) were investigated over a 2‐year study period. Results Between January 31, 2012, and January 31, 2014, 460 neonates were admitted to the NICU, 83 of whom exhibited some kind of ISI. The major risk factors for ISIs were low birthweight, young gestational age, long NICU stay, use of the intubation–surfactant–extubation (INSURE) technique, surfactant use, mechanical ventilation, insertion of an umbilical arterial catheter, circulatory and cardiac support with dopamine or dobutamine, pulmonary hemorrhage, intracranial hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, and positive microbiology culture results. Conclusion To prevent ISIs, careful consideration of risk factors and the creation of protocols ensuring efficient treatment of injuries are needed.