The Effect of Bladder Stimulation Technique on Urine Specimen Collection in Newborns
NCT ID: NCT05416736
Last Updated: 2022-11-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
COMPLETED
NA
64 participants
INTERVENTIONAL
2021-10-15
2022-11-01
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
The Effect Of Finger Pupiling On Pain And Physiological Parameters in İnfants
NCT05412719
Evaluation of the Effectiveness of Non-pharmacological Methods During Heel Blood Collection
NCT05051267
The Effect of Facilitated Tucking After Vaginal Delivery on Late Preterm Stress, Comfort and Physiological Parameters
NCT05430321
The Efficacy of Non-pharmacological Interventions on Pain Levels, Crying Times and Voice Decibels in Newborns
NCT04033874
Simulation Techniques Used in Breech Birth Management Training
NCT05827627
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
One of the non-invasive methods used to collect urine samples is the use of sterile urine collection bags (Herreros Fernández et al., 2013). This method is not an effective method due to its high false positive rate, time consuming, delayed treatment, skin irritation and high risk of contamination (Finnell et al., 2011; Kaufman et al., 2020). Therefore, sterile urine bags should be used in urinalysis instead of urine culture (Balighian \& Review, 2018). Clean-caught urine provides an acceptable urine sample for the diagnosis of UTI. However, this method is possible for children with sphincter control (Altuntas et al., 2015; Kaufman et al., 2019).
A technique was recently described that allows midstream urine specimen collection in children without sphincter control. The technique, consisting of bladder stimulation and lumbar paravertebral massage, was successful in 86% of newborns, with an average duration of 57 seconds (Herreros Fernández et al., 2013). Previous studies have evaluated the technique's success rate and processing time (Altuntas et al., 2015, Labrosse et al., 2016, Crombie et al., 2020), contamination rate (Herreros et al., 2021), and cost (Kaufman et al., 2020) examined. Examination of the effect of the technique on the comfort and physiological parameters of the newborn will contribute to more information about the technique.
The aim of this study is to evaluate the effect of bladder stimulation technique on procedural success, procedure time, physiological parameters and comfort in urine specimen collection in newborns.
Study Population and Sampling The population of the research will be the newborns followed in the neonatal intensive care unit. The sample will consist of 64 (Experimental group = 32, Control group = 32) newborns who meet the inclusion criteria of the study. In calculating the sample size, Altuntaş et al. (2015) benefited from the study. Considering the success rates; The minimum number of samples to be taken was determined as 64 (Experimental group=32, Control group=32) with 95% confidence (1-α), 95% test power (1-β), w=0.453 effect size.
Randomization Infants meeting the research inclusion criteria will be divided into experimental and control groups using a computer-based program (https://www.randomizer.org).
Data Collection Method: The data will be collected by the a researcher in the unit where the study is planned to be carried out.
* Data Collection Form: Prepared by the researcher. The form includes questions about the infant's age, weight, gender, fever, heartbeat, saturation level, Comfortneo scale score, and procedure success and duration of the procedure.
* Comfortneo scale: Developed by Ambuel et al. (Ambuel et.al. 1992). Van Dijk et al. revised the COMFORTneo scale to measure behavior in newborns without physiological parameters (Van Dijk et. al. 2009). Turkish validity and reliability of the scale Kahraman et al. (Kahraman et. al 2014). The scale consists of 7 items: muscle tone, alertness, facial tension, calmness/agitation, body movements, respiratory response, and crying. "Respiratory response" is scored in infants on mechanical ventilator, and "crying" is scored in spontaneously breathing infants. A total score is calculated over 6 items. The lowest score that can be obtained from this scale is 6, and the highest score is 30. A high score indicates that the baby is not comfortable and needs interventions to provide comfort (Kahraman et. al 2014).
* Pulse Oximeter Device to detect infants' oxygen saturation (SPO2) and heart rate (HR)
* Weighing Tool to determine the current weight of babies.
* Thermometer to determine babies' body temperature
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Experimental Group
* Newborns will be fed with formula or breast milk pumped, according to the age and weight of the baby.
* Before the procedure, the newborn's heart rate, saturation and comfort scale score will be recorded.
* Genital area will be cleaned.
* Newborn will be held under the armpit by a nurse, baby boys will be held with their legs hanging down, and baby girls will be held in hip flexion position.
* Newborn with spontaneous voiding during the period from the beginning of the research procedure until the newborn is positioned will be excluded from the study.
* The bladder stimulation technique will be repeated sequentially for 3 minutes until micturition begins.
* After the maneuvers are started, the newborn's heart rate and saturation comfort scale score will be recorded at the 1st and 3rd minutes.
* The success of the procedure and the duration of the procedure will be recorded
The bladder stimulation technique
The bladder stimulation technique consists of two consecutive maneuvers. In the first maneuver, the bladder is stimulated by tapping the suprapubic region for 30 seconds at a frequency of 100 touches per minute. In the second maneuver, circular massage is applied to the paravertebral region for 30 seconds. The two stimulation maneuvers will be repeated alternately for 3 minutes (180 seconds) until micturition begins. Maneuvers will be performed by the researcher. Infants in both groups will be held under the armpit by a parent, male infants will be held in the drooping legs, and female infants will be held in the hip flexion position.
Control Group
* Newborns will be fed with formula or breast milk pumped, according to the age and weight of the baby.
* Before the procedure, the newborn's heart rate, saturation and comfort scale score will be recorded.
* Genital area will be cleaned.
* Newborns will be fitted with a sterile urine bag suitable for their gender.
* Babies who urinate spontaneously during the period until the sterile urine bag is fitted, the next feeding hour will be waited.
* Newborn will be observed for 3 minutes. Newborn's heart rate and saturation comfort pain scale score will be recorded at the 1st and 3rd minutes.
* The success of the procedure and the duration of the procedure will be recorded
Steril urine bag
Steril urine bag are attached to the genital area to collect urine samples
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
The bladder stimulation technique
The bladder stimulation technique consists of two consecutive maneuvers. In the first maneuver, the bladder is stimulated by tapping the suprapubic region for 30 seconds at a frequency of 100 touches per minute. In the second maneuver, circular massage is applied to the paravertebral region for 30 seconds. The two stimulation maneuvers will be repeated alternately for 3 minutes (180 seconds) until micturition begins. Maneuvers will be performed by the researcher. Infants in both groups will be held under the armpit by a parent, male infants will be held in the drooping legs, and female infants will be held in the hip flexion position.
Steril urine bag
Steril urine bag are attached to the genital area to collect urine samples
Other Intervention Names
Discover alternative or legacy names that may be used to describe the listed interventions across different sources.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Collecting urine specimen
* Being fed orally
* Having written consent from parents
Exclusion Criteria
* Poor feding
* Dehydration
* Oliguria/anuria
* Treatment with nephrotoxic drugs
* Serious illnesses affecting the mobility of the baby
* Having neurological and anatomical anomalies that may affect bladder function Any condition (meningocele, meningomyelocele etc.) that will prevent the implementation of the stimulation maneuver
3 Days
28 Days
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Istanbul University - Cerrahpasa
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Nihan Korkmaz
Research assistant
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Fatma Narter Kaya
Role: PRINCIPAL_INVESTIGATOR
Kartal Dr. Lütfi Kirdar City Hospital
Birsen Mutlu
Role: PRINCIPAL_INVESTIGATOR
Istanbul University - Cerrahpasa
Nihan Korkmaz
Role: PRINCIPAL_INVESTIGATOR
Istanbul University - Cerrahpasa
Kadriye Şahin
Role: PRINCIPAL_INVESTIGATOR
Istanbul University - Cerrahpasa
Hande Özgürü
Role: PRINCIPAL_INVESTIGATOR
Kartal Dr. Lütfi Kirdar City Hospital
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Nihan Korkmaz
Şişli, Istanbul, Turkey (Türkiye)
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Herreros Fernandez ML, Gonzalez Merino N, Tagarro Garcia A, Perez Seoane B, de la Serna Martinez M, Contreras Abad MT, Garcia-Pose A. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013 Jan;98(1):27-9. doi: 10.1136/archdischild-2012-301872. Epub 2012 Nov 21.
Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatr Int Child Health. 2017 Nov;37(4):273-279. doi: 10.1080/20469047.2017.1382046. Epub 2017 Oct 5.
Velasco R, Benito H, Mozun R, Trujillo JE, Merino PA, Mintegi S; Group for the Study of Febrile Infant of the RISeuP-SPERG Network. Febrile young infants with altered urinalysis at low risk for invasive bacterial infection. a Spanish Pediatric Emergency Research Network's Study. Pediatr Infect Dis J. 2015 Jan;34(1):17-21. doi: 10.1097/INF.0000000000000482.
SUBCOMMITTEE ON URINARY TRACT INFECTION. Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2-24 Months of Age. Pediatrics. 2016 Dec;138(6):e20163026. doi: 10.1542/peds.2016-3026. No abstract available.
Finnell SM, Carroll AE, Downs SM; Subcommittee on Urinary Tract Infection. Technical report-Diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics. 2011 Sep;128(3):e749-70. doi: 10.1542/peds.2011-1332. Epub 2011 Aug 28.
Kaufman J. How to... collect urine samples from young children. Arch Dis Child Educ Pract Ed. 2020 Jun;105(3):164-171. doi: 10.1136/archdischild-2019-317237. Epub 2019 Aug 23.
Balighian E, Burke M. Urinary Tract Infections in Children. Pediatr Rev. 2018 Jan;39(1):3-12. doi: 10.1542/pir.2017-0007. No abstract available.
Altuntas N, Tayfur AC, Kocak M, Razi HC, Akkurt S. Midstream clean-catch urine collection in newborns: a randomized controlled study. Eur J Pediatr. 2015 May;174(5):577-82. doi: 10.1007/s00431-014-2434-z. Epub 2014 Oct 17.
Labrosse M, Levy A, Autmizguine J, Gravel J. Evaluation of a New Strategy for Clean-Catch Urine in Infants. Pediatrics. 2016 Sep;138(3):e20160573. doi: 10.1542/peds.2016-0573. Epub 2016 Aug 19.
Crombie T, Slinger R, Barrowman NJ, McGahern C, Smith L, Chu J, McCoy K, Akiki S, Agarwal A, Plint AC. Pragmatic evaluation of a midstream urine collection technique for infants in the emergency department. CJEM. 2020 Sep;22(5):665-672. doi: 10.1017/cem.2020.31.
Herreros ML, Gili P, Del Valle R, Barrios A, Pacheco M, Sanchez A. Urine collection methods for infants under 3 months of age in clinical practice. Pediatr Nephrol. 2021 Dec;36(12):3899-3904. doi: 10.1007/s00467-021-05142-4. Epub 2021 Jun 7.
Kaufman J, Knight AJ, Bryant PA, Babl FE, Dalziel K. Liquid gold: the cost-effectiveness of urine sample collection methods for young precontinent children. Arch Dis Child. 2020 Mar;105(3):253-259. doi: 10.1136/archdischild-2019-317561. Epub 2019 Aug 23.
Ambuel B, Hamlett KW, Marx CM, Blumer JL. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol. 1992 Feb;17(1):95-109. doi: 10.1093/jpepsy/17.1.95.
van Dijk M, Roofthooft DW, Anand KJ, Guldemond F, de Graaf J, Simons S, de Jager Y, van Goudoever JB, Tibboel D. Taking up the challenge of measuring prolonged pain in (premature) neonates: the COMFORTneo scale seems promising. Clin J Pain. 2009 Sep;25(7):607-16. doi: 10.1097/AJP.0b013e3181a5b52a.
Kahraman A, Başbakkal Z, Yalaz M. Turkish Validity And Reliability Of Comfortneo Scale. International Refereed Journal of Nursing Research. 2014; 1: 1-11
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
Nihan
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.