Neonatal thermoregulation

 BACKGROUND: Hypothermia incurred during delivery room resuscitation continues to cause morbidity in infants <29 weeks gestation. Three recent trials have shown that wrapping such infants instead of drying prevents heat loss, resulting in higher infant temperatures at Newborn Intensive Care Unit (NICU) admission.
OBJECTIVE: To describe current NICU practices with respect to wrapping preterm infants to prevent heat loss in the delivery room.
STUDY DESIGN: E-mail survey of neonatologists from national registry using a web-based survey tool.

 OBJECTIVE: Preterm infants are prone to hypothermia immediately following birth. Among other factors, excessive evaporative heat loss and the relatively cool ambient temperature of the delivery room may be important contributors. Most infants <29 weeks gestation had temperatures <36.4°C on admission to our neonatal unit (NICU). Therefore we conducted a randomized, controlled trial to evaluate the effect of placing these infants in polyurethane bags in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the NICU.

 Background: ELBW infants are vulnerable to cold stress during the transition from delivery room to intensive care. Infants produce heat by non-shivering thermogenesis (NST) and should exhibit peripheral vasoconstriction when cold, but little empirical evidence confirms that ELBW infants are capable of peripheral vasoconstriction.
Objective: This study evaluated the ability of ELBW infants weighing 400–1000 grams to exhibit peripheral vasoconstriction when body temperatures decreased.

 Objective: To explore body temperature in relationship to heart rate in extremely low birth weight (ELBW) infants
during their first 12 hours to help identify the ideal set point for incubator control of body temperature.
Design: Within subject, multiple-case design.
Setting: A tertiary neonatal intensive care unit (NICU) in North Carolina.
Participants: Ten infants born at fewer than 29 weeks gestation and weighing 400 to 1,000 g.

Extremely low-birthweight infants have inefficient thermoregulation due to immaturity and may exhibit cold body temperatures after birth and during their first 12 hours of life. Hypothermia in these infants can lead to increased morbidity and mortality. Anecdotal notes made during our recent study revealed extremely low-birthweight infants’ temperatures decreased with caregiver procedures such as umbilical line insertion, intubations, obtaining chest x-rays, manipulating intravenous lines, repositioning, suctioning, and taking vital signs during the first 12 hours of life.