Efeito do óleo de girassol comparado ao hidrocoloide para prevenção de lesão cutânea nos prematuros em uso de CPAP nasal: estudo piloto de ensaio clínico randomizado.

Abstract

Non-invasive mechanical ventilation using continuous positive airway pressure, Continuous Positive Airway Pressure (CPAP) with prongs, has been used routinely for premature infants with respiratory problems. Its use is related to the high rate of skin lesions, requiring monitoring and intervention by the nursing team. Thus, the aim of this study was to evaluate the relevance of methods, instruments and sample size, seeking to evaluate the effect of sunflower oil based on essential fatty acids compared to hydrocolloid in preventing skin damage in premature infants using nasal CPAP. This is a pilot study of a randomized controlled, prospective, parallel, two-arm clinical trial with a 1: 1 allocation rate. The sample consisted of 40 premature infants hospitalized in the Neonatal Intensive Care Unit, the experimental group as sunflower oil (n = 20) and the control group with hydrocolloid (n = 20). Data collection took place from January to July 2019, using the instruments for characterization, daily monitoring of premature infants and nasal CPAP, daily assessment of skin condition (Newborn Skin Condition Scale) and classification system (International Pressure Injury Classification System). For data analysis, Student's t-test, Fischer's exact test, Odds Ratio, Wilcoxon-Mann-Whitney test were used and for the correlation of the main variables (scales) by Spearman's correlation coefficient, the level of significance of p ≤ 0.05. In the results, the methods used showed feasibility to the planning and the strategies of sample recruitment, data collection, sample availability and the instruments were adequate in terms of applicability. The evaluation of the skin condition using the Newborn Skin Condition Scale, found that the experimental group (sunflower oil) is seven times more likely to have intact skin compared to the control group (hydrocolloid), being statistically significant (p <0.001). The positive and significant effect of sunflower oil on the hydrocolloid is also evident in the assessment of the degree of injury (p = 0.007). When correlating the scales of skin condition and the degree of injury, they were found to be highly correlated (R = 0.945) and statistically significant. It is concluded that this study design is feasible for a more robust RCT. The intervention proposed in the experimental group (sunflower oil) is easy to apply and has a low financial cost and has proved to be innovative in maintaining skin integrity and reducing the degree of injury when compared to the control group (hydrocolloid).