Pain assessment during eye examination for retinopathy of prematurity screening: Skin conductance versus PIPP-R.

AIM: To assess changes in skin conductance during retinopathy of prematurity screening and to study the correlation between the skin conductance and a validated pain scale. METHODS: Prospective observational study. Fifty-three eye examinations were performed in 32 preterm infant candidates for retinopathy of prematurity screening. Outcome measures were changes in Premature Infant Pain Profile-Revised (PIPP-R) scale and number of skin conductance fluctuations. RESULTS: There was a significant increase from baseline in the number of skin conductance fluctuations and PIPP-R during the procedure. The maximum value of number of skin conductance fluctuations was 0.64 ± 0.44 peaks/sec, and the maximum value of PIPP-R was 10.8 ± 3.3. A correlation between the skin conductance and PIPP-R was not found at any time during the eye examination. Repeated measures correlation analyses showed only a moderate positive correlation between PIPP-R and number of skin conductance fluctuation values. CONCLUSION: There were significant changes in both PIPP-R and number of skin conductance fluctuations during retinopathy of prematurity screening, reaffirming that this procedure is painful and stressful. The number of skin conductance fluctuations and PIPP-R are not significantly correlated, which likely reflects that these parameters evaluate different but complementary aspects of neonatal pain responses.

Efecto de las medidas de protección de la lactancia materna sobre sus tasas al alta en una unidad de neonatología de tercer nivel / Effect of measures to protect breastfeeding described by high rates in a third-level neonatology unit

INTRODUCCIÓN: Proteger la lactancia de aquellas madres con deseo de lactar garantiza mejores resultados de salud en el neonato tanto a corto como a largo plazo. OBJETIVOS: Conocer el efecto de las medidas de protección de Lactancia Materna (LM) sobre la tasa de la LM exclusiva al alta y el perfil relacionado. MÉTODOS: Estudio observacional y retrospectivo realizado en una Unidad de Neonatología de Tercer Nivel. Se dispuso de una muestra de 171 neonatos reclutados desde el 26 de enero de 2017 y el 20 de julio de 2018. CRITERIOS DE INCLUSIÓN: deseo expreso de la madre de lactar reflejado en la hoja de Partos y la existencia de la Ficha de LM del neonato de la Unidad. Se aplicó el test Chi-cuadrado de Pearson y la t de Student según correspondiera, considerándose un valor significativo de p < 0,05. RESULTADOS: La incidencia de LM exclusiva (LME) fue del 63,8% (54,4% administración directa o al pecho y el 9,4% administración diferida mediante jeringa, como método de no interferencia, o biberón. El 10,5% ofreció leche de fórmula y el 25,7% lactancia mixta (LM no exclusiva - LMNE). Como factores relacionados en la instauración de LME hubo mayor incidencia de ésta en los neonatos procedentes del domicilio frente a los ingresados desde partos (25,8% vs 9,7%, p = 0,012); en los prematuros mayores de 32 semanas frente a los menores (71% vs. 29%, p = 0,044). DISCUSIÓN: Asumimos que el 10,5% de las madres que ofrecieron leche de fórmula exclusiva revocaron expresamente su deseo de lactar. Sin embargo, un 25,7% de madres no consiguieron cubrir las necesidades con leche materna, necesitando suplementar con leche de fórmula. CONCLUSIONES: Dotar a las Unidades de Neonatología de personal cualificado en esta materia mejoraría la tasa de LME y en consecuencia la salud del binomio madre-neonato

INTRODUCTION: Protecting the breastfeeding of those mothers with a desire to breastfeed guarantees better health outcomes in the neonate both in the short and long term. OBJECTIVES: To know the effect of breastfeeding protection measures on the rate of exclusive breastfeeding at discharge and the related profile. METHODS: Observational and retrospective study conducted in a Third Level Neonatal Unit. A sample of 171 infants recruited from January 26, 2017 and July 20, 2018 was available. Criteria for inclusion: express wish of the mother to breastfeed as reflected in the birthsheet and the existence of the Breastfeeding Card of the newborn of the Unit. Pearson Chi-square test and Student's t test were applied as appropriate, considering a significant value of p <0.05. RESULTS: The rate of exclusive breastfeeding was 63.8% (54.4% direct or chest administration and 9.4% deferred administration by syringe, as a non-interference method, or bottle. The 10% offered formula and 25.7% mixed breastfeeding. As factors related to the establishment of breastfeeding, there was a higher incidence of this in the neonates from the home compared to those admitted from birth (25.8% vs 9.7%, p = 0.012), in preterm infants older than 32 weeks compared to the younger ones (71% vs. 29%, p = 0.044). DISCUSSION: We assume that 10.5% of mothers who offered exclusively formula milk expressly revoked their desire to breastfeed. However, 25.7% of mothers failed to meet the needs with breast milk, needing to supplement with formula. CONCLUSIONS: Providing Neonatology Units with qualified personnel in this area would improve the breastfeeding rate and consequently, the health of the mother-neonate binomial