Soppi Esa, Torra I Bou Joan-Enric

1. Carital Neo®, a Unique Mattress
Solution for NICU and PICU
Esa Soppi, M.D. PhD, Medical director, Carital Group,
Finland
Joan-Enric Torra I Bou. RN. Msc, Clinical Manager,
Smith&Nephew Iberia
Conclusions:
Carital Neo is a unique solution for neonatal and pediatric ICUs
Dynamic, automatically personalized-adjusting to optimum,
not alternating, modular air system
Proven efficacy and effectiveness in PU prevention in extremely
sick individuals
Unique stability, making it suitable also for ECMO, fracture and
spinal cord injury patients

2. Introduction
• Pressure ulcers are an avoidable problem with a great
personal, institutional and social impact.
• Children and neonates cared in intensive care units that are
immobile, are at high risk of developing pressure ulcers
related with the sleeping and resting surfaces.
• Carital Optima®, dynamic air mattress system adjusting
automatically and always optimally to minimum pressure
irrespective of patient’s weight and body shape, and which
is the parent for Carital Neo® mattress system, has been
shown to be highly effective in prevention of development
of pressure ulcers in extremely sick patients in ICU setting
(Takala J, Varmavuo S, Soppi E. Prevention of pressure sores in acute respiratory failure:
a randomized, controlled trial. Clin Intensive Care 7: 228-235, 1996).
2

3. Royal Children’s Hospital (RCH),
Melbourne, Australia, experience
• PICU in RCH is one of the largest users of Carital
products in the world
• More than 1500 infants and children of all medical and
surgical pediatric subspecialties are admitted yearly.
– The unit has a high acuity, with 70% of admissions requiring
intubation and mechanical ventilation.
– Approximately 30 ECMO, and 5-10 centrifugal ventricular
assist device (VAD) procedures are carried out yearly in the
unit and about 50 % of the patients are neonates.
• Still the hospital’s quality of care reports (2006-2011)
indicate very low numbers of pressure injuries i.e. about
5/year meaning incidence below 1 %. 3

4. Occurence of PUs on Carital
pediatric products
Support
surface
Weight (kg) Scale
(cut-off)
Average PICU
stay (d)
PUs
Carital Neo
(age < 1 mo)
(N=5)
4.6 13.2 (> 13)
(NSRAS)
5 0
Carital Juve
(age > 1 mo)
(N = 25)
10.3 10.4 (< 16)
(Braden-Q)
7.3 1*
Historical incidence of 20 % in the same unit during the previous years without Carital products
4
*20 months old child with for a non-Hodgkin lymphoma, weighed 10 kg, a Braden-Q risk score
of 8. Over 14 days on Carital Juve, the child was intubated, received parenteral and enteral
nutrition, and venous, arterial, and urinary catheters were used. Vasoactive and sedation drugs
were administered, together with heel protection dressings. The new PU developed in the
occipital area on the ninth day, and the patient died 15 days after admission in PICU.
García-Molina P, et al. Ostomy Wound Management 2012;58(7):32–39

5. Testing with the neonatal manikin,
5
Manikin is resembling a neonate, weight 2030 g on hard surface
Hard surface Foam mattress Carital Neo
Max IF
pressure,
mmHg
(SD)
Mean
interface
pressure,
mmHg
(SD)
Contact
area, cm2
(SD)
Max IF
pressure,
mmHg
(SD)
Mean
interface
pressure,
mmHg
(SD)
Contact
area, cm2
(SD)
Max IF
pressure,
mmHg
(SD)
Mean
interface
pressure,
mmHg
(SD)
Contact
area, cm2
(SD)
>100,0
( - )
12,0
(0,3)
133,4
(0,9)
43,2
(2.8)
6,9
(0,3)
178,7
(2,8)
38,0
(1,3)
4,8
(0,1)
195,9
(2,5)