Effects of Topical Emollient Therapy on Infants at or Less than 27 Weeks’ Gestation. DISCUSSION
When Aquaphor was applied to their skin, extremely-preterm infants required less fluids and had better urine output. Also, their serum potassium and bilirubin values were lower during the first two weeks of life. Fluctuations in glucose and sodium values were minimal and the values were lower in treated infants, compared to controls, but differences did not reach statistical significance. We believe glucose values were lower because these infants required significantly lower volumes of fluid. Sodium and bilirubin values were lower due to better hydration status.
Nopper et al. proved that there were effective reductions in transepidermal water losses with topical emollient therapy, but the fluid intake was similar in both groups. This was probably due to the initial time lag for the subjects to enter the study (approximately 96 hours) and the relative maturity of infants in the study (mean birthweight and GA were approximately 1,200 g and 29 weeks, respectively). Pabst et al. found that fluid intake was higher in the control group compared to the Aquaphor group, even though it did not reach statistical significance (P=0.08). There were only 11 infants in the study group and eight control infants in this study, and the infants were relatively more mature with a mean birthweight of 1,011 g to 1,143 g and a mean GA of approximately 28 weeks. In our study, infants are more immature with a mean GA of 25 weeks with a mean birthweight near 700 g. It appears that benefits of Aquaphor on fluids and electrolytes are more pronounced in lower-birth-weight and younger-GA infants. Hypernatremia, hyperkalemia and hyperbilirubinemia are common problems in these small preterm infants, hence the inclusion of these factors in our study. Other stud-ies, did not include all electrolytes and bilirubin as part of the evaluation. When you can’t afford your medication buy online pioglitazone drug
With an application of Aquaphor every six hours to the skin of preterm infants, we did not witness any toxic or local reactions. We had more problems with cardiac monitor lead placement and temperature probes, as did Nopper et al. Parents became involved in the application of the emollient and seemed to look forward to those times in the day. The practice of topical emollient therapy may have encouraged bonding between parents and infants, at a time that is frightening and creates much anxiety during a NICU stay. The strength of this study is that it has a relatively large number of infants in the low-est-birthweight category, compared to the previous studies. The study limitations are its retrospective nature and its use of historical controls. buy skelaxin online
In conclusion, infants <27 weeks’ gestation who had the Aquaphor emollient applied to their skin from birth required less fluids, had better urine output, more stable electrolytes and lower bilirubin values during their first two weeks of life. Therefore, we conclude that the topical emollient cream, Aquaphor, applied to the skin of extremely preterm infants is beneficial, particularly for fluids and electrolyte management. buy sumatriptan