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OBJECTIVE: To analyze the skin injuries of hospitalized newborns and identify factors related to the number of lesions. METHOD: This was a cross-sectional epidemiological study carried out over a period of one year in a Neonatal Intensive Care Unit in the west of Paraná. The study included 74 newborns with a score ≥5 on the Newborn Skin Condition Scale. Data analysis by chi-square and Pearson's test (p < 0.05). RESULTS: The frequency was 25.4%, 59.4% had more than one lesion, mainly dermatitis and pressure injury. Birth characteristics were not related to the number of lesions. Not using antibiotics and parenteral nutrition, hemoglobin >11g/dl, phototherapy, pain score <4 and hospitalization >30 days were related to the number of lesions. The presence of two injuries led to longer healing time and three to longer hospitalization. A higher score on the Skin Condition Scale was related to healing time and late start of the diet. CONCLUSION: Skin injuries were found to be infrequent among newborns, but there is still a need to improve practices to prevent and maintain skin integrity.

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ABSTRACT Objective: To analyze the skin injuries of hospitalized newborns and identify factors related to the number of lesions. Method: This was a cross-sectional epidemiological study carried out over a period of one year in a Neonatal Intensive Care Unit in the west of Paraná. The study included 74 newborns with a score ≥5 on the Newborn Skin Condition Scale. Data analysis by chi-square and Pearson's test (p < 0.05). Results: The frequency was 25.4%, 59.4% had more than one lesion, mainly dermatitis and pressure injury. Birth characteristics were not related to the number of lesions. Not using antibiotics and parenteral nutrition, hemoglobin >11g/dl, phototherapy, pain score <4 and hospitalization >30 days were related to the number of lesions. The presence of two injuries led to longer healing time and three to longer hospitalization. A higher score on the Skin Condition Scale was related to healing time and late start of the diet. Conclusion: Skin injuries were found to be infrequent among newborns, but there is still a need to improve practices to prevent and maintain skin integrity.

RESUMEN Objetivo: Analizar las lesiones cutáneas en recién nacidos hospitalizados e identificar los factores relacionados con el número de lesiones. Material y método: Estudio epidemiológico transversal realizado durante un año en una unidad de terapia intensiva neonatal del oeste de Paraná. Fueron incluidos 74 recién nacidos con puntuación ≥5 en la Escala de Estado de la Piel del Recién Nacido. Los datos se analizaron mediante chi-cuadrado y test de Pearson (p < 0,05). Resultados: La frecuencia fue del 25,4%, el 59,4% presentaba más de una lesión, principalmente dermatitis y lesiones por presión. Las características del nacimiento no se relacionaron con el número de lesiones. No utilizar antibióticos ni nutrición parenteral, hemoglobina >11g/dl, fototerapia, puntuación del dolor <4 y hospitalización >30 días se relacionaron con el número de lesiones. La presencia de dos lesiones conllevaba un mayor tiempo de curación y tres una hospitalización más prolongada. Una puntuación más alta en la escala de estado de la piel se relacionó con el tiempo de curación y el inicio tardío de la dieta. Conclusión: Se observó que las lesiones cutáneas son poco frecuentes entre los recién nacidos, pero sigue siendo necesario mejorar las prácticas de prevención y mantenimiento de la integridad de la piel.

RESUMO Objetivo: Analisar as lesões de pele de recém-nascidos hospitalizados e identificar fatores relacionados ao número de lesões. Método: Estudo epidemiológico seccional, realizado no período de um ano, em Unidade de Terapia Intensiva Neonatal do Oeste do Paraná. Foram incluídos 74 recém-nascidos com escore ≥5 na Escala de Condição da Pele do Recém-Nascido. Análise de dados por teste qui-quadrado e Pearson (p < 0,05). Resultados: A frequência foi de 25,4%, 59,4% apresentaram mais de uma lesão, principalmente dermatites e lesão por pressão. Características do nascimento não se relacionaram ao número de lesões. Não usar antibióticos e nutrição parenteral, hemoglobina >11g/dl, fototerapia, escore de dor <4 e hospitalização >30 dias foram relacionados ao número de lesões. Presença de duas lesões levou maior tempo de cicatrização e três, de hospitalização. Maior escore na Escala de Condição da Pele se relacionou ao tempo de cicatrização e início tardio da dieta. Conclusão: A lesão de pele mostrou-se pouco frequente entre os recém-nascidos, mesmo assim, é preciso aprimorar as práticas para prevenir e manter a integridade da pele.

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OBJECTIVE: Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. METHODS: This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. RESULTS: No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. CONCLUSION: Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.

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ABSTRACT Objective Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. Subjects and methods This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. Results No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. Conclusions Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.

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Objetivo: Relacionar a evolução do perfil lipídico, glicêmico e pressórico de prematuro do nascimento aos 2 anos de idade corrigida com a classificação de peso ao nascer e sexo. Metodologia: Estudo longitudinal, amostra inicial de 71 prematuros, destes, 31 completaram o acompanhamento ambulatorial. Avaliados ao nascer, alta, 6 meses e 2 anos de idade corrigida (peso, idade gestacional, perfil lipídico, glicêmico, pressão arterial). Resultados: Glicemia, colesterol total, pressão arterial e triglicerídeos, não foram estatisticamente significantes em relação ao peso ao nascer e ao longo do seguimento. Colesterol total (p=0,18) e glicemia sofreram efeito de interação com o sexo. Pressão arterial acima do esperado aos 2 anos. Crescimento foi uniforme independente do sexo. Conclusão: O perfil lipídico, glicêmico e pressórico dos prematuros ao longo do acompanhamento não foi influenciado pela classificação de peso ao nascer. O sexo influenciou as concentrações de colesterol e a glicemia.

Objective: To relate the evolution of the lipid, glycemic and blood pressure profile of premature infants from birth to 2 years corrected age with the classification of birth weight and sex. Methodology: Longitudinal study, initial sample of 71 premature infants, of which 31 completed outpatient follow-up. Evaluated at birth, discharge, 6 months and 2 years corrected age (weight, gestational age, lipid, glycemic, blood pressure profile). Results: Blood glucose, total cholesterol, blood pressure and triglycerides were not statistically significant in relation to birth weight nor throughout follow-up. Total cholesterol (p=0.18) and blood glucose underwent interaction with sex. Blood pressure was higher than expected at 2 years old. Growth was uniform regardless of sex. Conclusion: The lipid, glycemic and blood pressure profile of premature infants during follow-up was not influenced by the birth weight classification. The cholesterol and blood glucose concentrations were influenced by sex.

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The present study characterized the plasma glycemic and lipid profiles in full-term newborn babies at birth and correlated these variables with growth markers and maternal clinical and metabolic conditions, to observe if maternal pregnancy conditions can influence metabolic programming in these newborn babies. Anthropometric and biochemical data were collected from 162 mother/newborn binomials at birth and at 6 months at a public hospital in Western Paraná State, Brazil. Samples of blood tests for glucose, insulin, total cholesterol, and triglycerides were obtained. Two classes of mothers/babies were statistically defined. The glycemic profiles in Class 1, at birth, were 63.0 ± 19.6 mg/dL and at 6 months 80.4 ± 10.6 mg/dL; in Class 2, at birth, they were 66.1 ± 20.8 mg/dL and at 6 months 78.2 ± 9.4 mg/dL. The triglycerides levels in Class 1 and Class 2, at birth, were 124.5 ± 47.8 mg/dL and 132.6 ± 60.2 mg/dL, respectively, and at 6 months they were 139.0 ± 51.5 mg/dL and 115.2 ± 39.9 mg/dL, respectively. Even though most of the pregnant women were overweight at the end of the gestation period, the anthropometric patterns found for babies followed the desirable standards. Furthermore, the average glycemic profile values were between the cutoff standards at birth and at 6 months; however, the triglycerides were above the expected values.

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Objetivo: Mensurar a carga de trabalho da equipe de enfermagem de uma Unidade de Terapia Intensiva Neonatal (UTIN) e dimensionar o quadro de pessoal necessário para o suprimento desta demanda. Metodologia: Estudo transversal, documental e quantitativo. Foram coletadas variáveis de caracterização clínica e demográfica da amostra (n=105) de recém-nascidos e da carga de trabalho da enfermagem por meio do Nursing Activities Score (NAS). O dimensionamento foi calculado com base em equação para terapia intensiva e ajustado à Resolução nº 543/2017 do Conselho Federal de Enfermagem. Resultados: A média do NAS da UTIN foi de 749,9. Obteve-se quadro dimensionado de 43 profissionais, com déficit de 17 enfermeiros em comparação ao quadro disponível. Conclusão: O quadro de enfermeiros da UTIN é insuficiente.

Objective: To measure the workload of the nursing team of a Neonatal Intensive Care Unit (NICU) and to size the personnel needed to supply this demand. Method: Cross-sectional, documentary and quantitative study. Clinical and demographic characterization variables of the sample (n = 105) of newborns and the nursing workload were collected through the Nursing Activities Score (NAS). The design was calculated based on a formula for intensive therapy and adjusted to Resolution 543/2017 of the Federal Nursing Council. Results: The mean of the NICU NAS was 749.9. It was obtained a dimensioned picture of 43 professionals, with a deficit of 17 nurses in comparison to the available picture. Conclusion: Nurses from the NICU are insufficient.

Objetivo: Medir la carga de trabajo del equipo de enfermería de una Unidad de Terapia Intensiva Neonatal (UTIN) y dimensionar el cuadro de personal necesario para el aprovisionamiento de esta demanda. Metodologia: Estudio transversal, documental y cuantitativo. Se recogieron variables de caracterización clínica y demográfica de la muestra (n = 105) de recién nacidos y de la carga de trabajo de la enfermería por medio del Nursing Activities Score (NAS). El dimensionamiento fue calculado con base en fórmula para terapia intensiva y ajustado a la Resolución 543/2017 del Consejo Federal de Enfermería. Resultados: El promedio del NAS de la UTIN fue de 749,9. Se obtuvo un cuadro dimensionado de 43 profesionales, con déficit de 17 enfermeros en comparación al cuadro disponible. Conclusión: El cuadro de enfermeros de la UTIN es insuficiente.

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OBJECTIVE: To compare the physiological and behavioral responses of Premature Infant (PREEMIE) positioned by the Unit Routine Decubitus (URD) and the Standard Operating Procedure (SOP). METHOD: A quasi-experimental comparative study performed at a Neonatal Intensive Care Unit in Southern Brazil. We evaluated 30 PREEMIEs with gestational age ≤32 weeks, randomly assigned to Unit Routine Decubitus (URD) and Intervention Group (IG), subdivided into Right Lateral Decubitus (RLD), Dorsal Decubitus (DD), Left Lateral Decubitus (LLD) and Ventral Decubitus (VD). It was evaluated before, during and after the procedure: Heart Rate (HR); Respiratory Frequency (RF); Peripheral Oxygen Saturation (SpO2); behavior by the Neonatal Behavioral Assessment Scale (NBAS); by NIPS. RESULTS: During the intervention, RR (p = 0.023), indexes in NBAS (p = 0.01) and NIPS (p <0.0001) reduced significantly in SOP. HR and SpO2 did not present a significant difference. CONCLUSION: Positioning according to the SOP shows benefit in relation to the behavioral and physiological status of PREEMIE.

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A sobrevida de recém-nascidos prematuros e de baixo peso tem evidenciado alterações metabólicas ao longo de suas vidas. Objetiva-se correlacionar se condições clínicas do recém-nascido prematuro (RNPT) ao nascimento, na hospitalização e após a alta da Unidade de Terapia Intensiva Neonatal, influenciam no seu perfil metabólico aos seis meses de Idade Corrigida. Estudo prospectivo, de coorte, com 37 RNPT. A análise estatística realizada foi descritiva e inferencial. Ao correlacionar as condições clínicas do nascimento, da hospitalização e do seguimento com o perfil metabólico do RNPT, evidenciou-se que a enterocolite necrotizante (p= 0,006) e sepse tardia (p= 0,02) apresentaram diferença estatística significativa na concentração de insulina. O perfil glicêmico na presença das comorbidades se manteve normal e o perfil lipídico elevou-se gradativamente. Os RNPT deste estudo constituem-se em grupo de risco para o desenvolvimento da síndrome metabólica e doenças cardiovasculares, devido às alterações lipídicas e insulínicas encontradas.

The survival of preterm newborns and low weight has shown the metabolic changes throughout their lives. The objective is to correlate if the clinical conditions of the preterm newborn (PTNB) at birth, during admission and after discharge from the Neonatal Intensive Care Unit, influence their metabolic profile at six months of Corrected Age. It is a prospective cohort study with 37 PTNB. The statistical analysis was descriptive and inferential. When correlating the clinical conditions at birth, during admission and at follow-up with the PTNB metabolic profile, the necrotizing enterocolitis (p=0.006) and late sepsis (p= 0.02) presented a significant statistical difference in the insulin concentration. The glycemic profile in the presence of comorbidities stayed normal and the lipidic profile gradually increased. The PTNB of this study constitutes a group at risk for the development of metabolic syndrome and cardiovascular diseases, due to lipidic and insulin changes found.

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ABSTRACT Objective: To compare the physiological and behavioral responses of Premature Infant (PREEMIE) positioned by the Unit Routine Decubitus (URD) and the Standard Operating Procedure (SOP). Method: A quasi-experimental comparative study performed at a Neonatal Intensive Care Unit in Southern Brazil. We evaluated 30 PREEMIEs with gestational age ≤32 weeks, randomly assigned to Unit Routine Decubitus (URD) and Intervention Group (IG), subdivided into Right Lateral Decubitus (RLD), Dorsal Decubitus (DD), Left Lateral Decubitus (LLD) and Ventral Decubitus (VD). It was evaluated before, during and after the procedure: Heart Rate (HR); Respiratory Frequency (RF); Peripheral Oxygen Saturation (SpO2); behavior by the Neonatal Behavioral Assessment Scale (NBAS); by NIPS. Results: During the intervention, RR (p = 0.023), indexes in NBAS (p = 0.01) and NIPS (p <0.0001) reduced significantly in SOP. HR and SpO2 did not present a significant difference. Conclusion: Positioning according to the SOP shows benefit in relation to the behavioral and physiological status of PREEMIE.

RESUMEN Objetivo: Comparar respuestas fisiológicas y comportamentales de Recién Nacidos Prematuros (RNPT) colocados por el Decúbito de Rutina de la Unidad (DRU) y por el Procedimiento Operativo Estándar (POE) de posicionamiento. Método: Estudio comparativo casi experimental, realizado en una Unidad de Terapia Intensiva Neonatal en el Sur de Brasil. Evaluados 30 RNPTS con la edad gestacional ≤32 semanas asignado, aleatoriamente, en Decúbito de Rutina de la Unidad (DRU) y Grupo Intervención (POE), este subdividido en Decúbito Lateral Derecho (DLD), Decúbito Dorsal (DD), Decúbito Lateral Izquierdo (DLI) y Decúbito Ventral (DV). Fueron evaluados antes, durante y después del procedimiento: La Frecuencia Cardíaca (FC); La Frecuencia Respiratoria (FR); La Saturación Periférica de Oxígeno (SpO2); el comportamiento por la Escala de Brazelton Modificada (EBM); el dolor por la NIPS. Resultados: Durante la intervención, FR (p=0,023), los índices en la EBM (p=0,01) y NIPS (p<0,0001) redujeron significativamente en el POE. FC y SpO2 no presentaron una diferencia significativa. Conclusión: El posicionamiento conforme el POE evidencia beneficio en relación al estado conductual y fisiológico de RNPT.

RESUMO Objetivo: Comparar respostas fisiológicas e comportamentais de Recém-Nascidos Prematuros (RNPT) posicionados pelo Decúbito de Rotina da Unidade (DRU) e pelo Procedimento Operacional Padrão (POP) de posicionamento. Método: Estudo comparativo quase experimental, realizado em uma Unidade de Terapia Intensiva Neonatal no Sul do Brasil. Avaliados 30 RNPTs com idade gestacional ≤32 semanas alocados, randomizadamente, em Decúbito de Rotina da Unidade (DRU) e Grupo Intervenção (POP), este subdividido em Decúbito Lateral Direito (DLD), Decúbito Dorsal (DD), Decúbito Lateral Esquerdo (DLE) e Decúbito Ventral (DV). Avaliou-se antes, durante e após o procedimento: Frequência Cardíaca (FC); Frequência Respiratória (FR); Saturação Periférica de Oxigênio (SpO2); comportamento pela Escala de Brazelton Modificada (EBM); dor pela NIPS. Resultados: Durante a intervenção, FR (p=0,023), índices na EBM (p=0,01) e NIPS (p<0,0001) reduziram significativamente no POP. FC e SpO2 não apresentaram uma diferença significativa. Conclusão: O posicionamento conforme o POP evidencia benefício em relação ao estado comportamental e fisiológico de RNPT.

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