Extremely low birth weight preterm infants lack vasomotor response in relationship to cold body temperatures at birth

Abstract

Objective This study evaluated peripheral vasoconstriction in ELBW infants when body temperature decreased during the first 12-hours of life. Design An exploratory, within-subjects design with 10 ELBW infants. Abdominal and foot temperatures were measured every minute. Peripheral vasoconstriction (abdominal > peripheral temperature by 2° C) and abdominal-peripheral temperature difference were also evaluated. Results Abdominal and peripheral temperatures were significantly correlated within each infant. One 880 g infant exhibited isolated peripheral vasoconstriction; a 960 g infant had abdominal temperatures more than 1° C higher than peripheral temperatures. Eight smaller infants exhibited no peripheral vasoconstriction and spent most of their observations with peripheral greater than abdominal temperatures. In 8 infants, mean temperature difference was significantly higher when abdominal temperature was less than 36.5° C. Conclusion Most ELBW infants did not exhibit peripheral vasoconstriction during their first 12-hours of life, despite low temperatures. ELBW infants’ vasomotor control may be immature during this period.

Infrared thermography for detailed registration of thermoregulation in premature infants

“…First, experimental setups differ: either a thermal bed with radiant warmer [16] or specific reconverted incubators [10,19,20,25] . Second, measurement intervals differ from 5 min [19,20,25] up to 4 h [16] , or no detailed information [10] . Third, the number of included patients differed [10,19,20,25] .…”

“…Study design and protocol were approved by the Ethics Committee of Aachen University Hospital (EK032/09) and written parental consent was obtained prior to enrolment. In former studies, authors applied IRT as an alternative method for measuring skin temperature in mature and premature infants with special experimental setups (reconverted incubators, radiant warmers) [3,10,12,16,19,20,25] , because external side eff ects such as variation of environmental temperature and variable air velocity and humidity can infl uence accurate skin measurement with IRT. Being aware of that, we performed a compensation method to obtain reliable results [2] .…”

“…Practically, this may be of importance, as the daily routine care (such as changing nappies) usually takes place soon after the premature infant was laid back into the incubator. To our knowledge, the technology of infrared thermography has not yet been investigated during SSC as has been proposed [20] . Therefore, our aim was to test the hypothesis that IRT reports showed temperature regulation, distribution and kinetics, and may help to clarify temperature regulation longitudinally on the approach of incubator care and SSC.…”

“…To avoid and/or register changes in body temperature of premature infants, it is standard to continuously measure skin or rectal body temperature by cable-bound sensors. Color infrared thermography (IRT) is a method to measure skin temperature distribution of mature [3,8] and premature [1,10,12,16,19,20,25] infants.…”

Role of effective thermoregulation in premature neonates

“…However, non-shivering thermogenesis is inefficient in infants less than about 32 weeks' gestational age due to developmental deficiencies, causing infants to lose more heat than they can generate and allowing for hypothermic body temperatures. [10][11][12] When an infant is delivered into a cold delivery room, covered with amniotic fluid, evaporative and convective heat loss is certain. Body temperatures can fall to extremely low levels if auxiliary heat is not provided.…”