Novel air mattress reduces interface pressure in neonatal and pediatric patients: a randomized controlled clinical trial

Pressure injuries are of critical concern in neonates in the intensive care unit, as this patient group is highly susceptible due to prolonged periods of immobility and their fragile skin. In a randomized crossover study, the impact of a novel air mattress on pressure distribution was investigated and compared with a conventional foam mattress. Interface pressure was measured using a high-resolution sensor mat. Analysis was performed across two anatomical regions (head and torso) at five predefined time points during a 60-minute observation period. The top 2% and 25% interface pressure values were analyzed, and exponential regression analysis was applied to assess temporal differences in interface pressure. The air mattress showed consistently lower interface pressures than the foam mattress. In the top 25% pressure values, pressures in the head region revealed a 36.5% reduction on the air mattress (median: 2.44 kPa, interquartile range (IQR): 2.19-2.89) compared to the foam mattress (median: 3.84 kPa, IQR: 3.27-4.55). This resulted in a 56.0% reduction in the proportion of potentially harmful and high risk pressure values for the air mattress. Similarly, in the torso region, pressures were 23.5% lower (median: 2.02 kPa vs. 2.64 kPa), reducing risk exposure by 61%. The air mattress showed lower pressure variability, indicated by narrower interquartile ranges than on the foam mattress. Foam mattress variability suggests potentially more movements that might be an indicator of discomfort. These results confirm the air mattress's capability to substantially reduce interface pressures in high-risk neonates, providing a basis for improving support surfaces to mitigate pressure injury risk.