Invasive procedures cause undesirable pain and stress in sick newborn infants. Mini-erosion dermal access (MEDA) is well documented with regard to systemic drug delivery (morphine, DDAVP) and glucose measurements in adults. This method has now been adapted for newborn infants.
Method: MEDA was obtained using a standardized suction technique(Sampling devices, Epiport, Sweden) in 24 newborn infants (28-42 gestational weeks) and evaluated by means of electron microscopy (EM), laser Doppler perfusion imaging (LDI) and evaporimetry. ISF was extracted serially during 1-3 days. Glucose levels in ISF were measured photometrically (adapted Hemocue, HC) vs. enzymatically (YSI) in umbilical arterial blood.
Results: The technique was applicable in all infants with no signs of pain or stress. The epidermal barrier with adjoining 2-3 layers of epidermal cells were split off reproducibly (EM). The LDI values (day 4) were 1.7±0.4 V (mean SD, access site) vs. 1.3±0.3 V (control, p<0.01), confirming the presence of the late phase of the dermal protective/regenerative response that has been described in adults (immediate and protracted dermal hyperemia, normal oxygenation). ISF was extracted serially at rates of 2-4 μL per minute, 12 times during 3 days, after which the skin barrier regenerated in 2-4 days (evaporation rates normalized). The site appeared normal at 7 days with no signs of complications. The ISF-HC glucose value was 3.5±1.0 mmol/L (mean±SD, range 1.9-6.6) vs. 3.7±1.0 mmol/L (range 2.0-5.4) for YSI (44 pairs).
Conclusion: MEDA is a feasible method for serial sampling of ISF and may become an alternative to conventional invasive blood sampling procedures in newborn infants. A modified sampling device (Epiport) is entering a testing stage.
Author information
Authors and Affiliations
Additional information
(Spon by: Sture Sjöblad) Funding by Epiport is acknowledged.
Rights and permissions
About this article
Cite this article
Hansen, I., Håkansson, K., Polberger, S. et al. Dermally Non-invasive Suctioning Technique for Painless Serial Sampling of Interstitial Fluid (ISF) in Newborn Infants 1525. Pediatr Res 43 (Suppl 4), 261 (1998). https://doi.org/10.1203/00006450-199804001-01547
Issue Date:
DOI: https://doi.org/10.1203/00006450-199804001-01547
This article is cited by
-
Plasma proteins in a standardised skin mini-erosion (I): permeability changes as a function of time
BMC Dermatology (2002)
-
Plasma proteins in a standardised skin mini-erosion (II): effects of extraction pressure
BMC Dermatology (2002)