Sunday, March 24, 2013

Urine collection in newborns


A New Technique for Fast and Safe Collection of Urine in Newborns

María Luisa Herreros Fernández, Noelia González Merino, Alfredo Tagarro García, Beatriz Pérez Seoane, María de la Serna Martínez, María Teresa Contreras Abad, Araceli García-Pose,
Arch Dis Child. 2013;98(1):27-29. 

Technique

Two people (trained nurses and/or physicians) were needed to perform the procedure, and a third to measure the time taken. This technique involves a combination of fluid intake and non-invasive bladder stimulation manoeuvres.
The first step is either breast-feeding or providing formula intake appropriate to the age and weight of the newborn. In babies fed infant formula, 10 ml was provided on the first day of life, increasing to 10ml per day during the first week. From the second week onwards, 25 ml/kg were administered before the onset of stimulation. Twenty-five minutes after feeding, the infant's genitals were cleaned thoroughly with warm water and soap and dried with sterile gauze. A sterile collector was placed near the baby in order to avoid losing urine samples. Before performing the technique, we administered non-pharmacological analgesia, such as non-nutritive sucking or 2% sucrose syrup, to prevent/lessen crying.
The second step is to hold the baby under their armpits with their legs dangling. One examiner then starts bladder stimulation which consists of a gentle tapping in the suprapubic area at a frequency of 100 taps or blows per minute for 30 s.
The third step is stimulation of the lumbar paravertebral zone in the lower back with a light circular massage for 30 s.
Both stimulation manoeuvres are repeated until micturition starts, and a midstream urine sample can be caught in a sterile collector (figure 1). Success is defined as the collection of a sample within 5 min of starting the stimulation manoeuvres.
Figure 1.
New stimulation technique to obtain midstream urine in newborns. (A) Tapping in the suprapubic area. (B) Stimulation of the lower back. (C) Midstream urine sample collection in a sterile container.

3 comments:

spencer shawn said...

I have heard that there are midstream urine collection devices. How do you use them? My doctor has been suggesting them.

Dr Tan Poh Tin said...

hi spencer,

I have not seen any of the devices - not sure if they are available in Malaysia.
Sure wish someone could design one!!
I really hated doing the suprapubic taps in neonates during my training days -it is such a scary n painful procedure for the doer as much as for the poor baby!

Jason Strong said...

I appreciate you sharing this! I've been looking for some insights on how midstream urine collections work, and this gave me some great insight! So far this and http://www.uriaid.com/products.html have been the most helpful. Thanks for sharing!