Head insulation and heat loss in the newborn.

Stothers, J. K.

doi:10.1136/adc.56.7.530

Cited by 72 publications

(29 citation statements)

References 12 publications

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“…It should therefore reflect daily routines and their influence on the infant's metabolism better than the older techniques which have been described. The use of a head canopy within the incubator (3, 12) comes closest to fulfilling these aims and allows measurements to continue while the infants are handled, but the canopy will itself influence the thermal environment of the infant's head and thus may affect oxygen consumption (22). It is an obvious disadvantage of our technique that the measurements cannot be made while the infant is actually being handled.…”

Section: Discussionmentioning

confidence: 99%

Respiratory Metabolism in Preterm Infants: the Measurement of Oxygen Consumpton during Prolonged Periods

Abdulrazzaq

Brooke

1984

Pediatr Res

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Section: Discussionmentioning

confidence: 99%

Respiratory Metabolism in Preterm Infants: the Measurement of Oxygen Consumpton during Prolonged Periods

Abdulrazzaq

Brooke

1984

Pediatr Res

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“…38 Apply plastic wrap to head immediately. 39,40 Apply stockinette hat over the plastic wrap. Apply plastic wrap around body of infant when ,29 wk gestational age.…”

Section: Evaluation Methodsmentioning

confidence: 99%

Decreasing Hypothermia During Delivery Room Stabilization of Preterm Neonates

Pinheiro¹,

Furdon²,

Boynton³

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Hypothermia during delivery room stabilization of very low birth weight (VLBW) newborns is independently associated with mortality, yet it occurred frequently both in collaborative networks and at our institution. We aimed to attain admission temperatures in the target range of 36°C to 38°C in $90% of inborn VLBW neonates through implementation of a thermoregulation bundle.METHODS: This quality improvement project extended over 60 consecutive months, using sequential plan-do-check-act cycles. During the 14 baseline months, we standardized temperature measurements and developed the Operation Toasty Tot thermoregulation bundle (including consistent head and torso wrapping with plastic, warmed blankets, and a closed stabilization room). We introduced this bundle in month 15 and added servo-controlled, battery-powered radiant warmers for stabilization and transfer in month 21. We provided results and feedback to staff throughout, using simple graphics and control charts.RESULTS: There were 164 inborn VLBW babies before and 477 after bundle implementation. Introduction and optimization of the bundle decreased the incidence of hypothermia, with rates remaining in the target range for the last 13 study months. The incidence of temperatures .38°C was ∼2% both before and after bundle implementation.CONCLUSIONS: This thermoregulation bundle resulted in sustained improvement in normothermia rates during delivery room stabilization of VLBW newborns. Our benchmark goal of $90% admission temperatures above 36°C was met without increasing hyperthermia rates. Because these results compare favorably with those of recently published research or improvement collaboratives, we aim to maintain our performance through routine surveillance of admission temperatures. Pediatrics 2014;133:e218-e226 Dr Pinheiro contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim and final data analyses and interpretation, and drafted the initial manuscript; Ms Furdon contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim data analyses and interpretation, and collaborated in the initial draft and revisions of the manuscript; Ms Boynton, Ms Dugan, and Ms Reu-Donlon contributed to the initial design and implementation of the project, collaborated in data acquisition, and reviewed and revised the manuscript; Ms Jensen contributed to the initial design and implementation of the project, performed data analyses and interpretation in the early phases of the project, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…While being dried, the baby should be on a warm surface, preferably the mother's chest or abdomen in skin-to-skin contact. The infant should then be clothed or covered, especially the head, 56 and kept in a warm environment, again usually best with the mother. Bathing should be delayed.…”

Section: Diagnosismentioning

confidence: 99%

Thermal protection of the newborn in resource-limited environments

2012

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Appropriate thermal protection of the newborn prevents hypothermia and its associated burden of morbidity and mortality. Yet, current global birth practices tend to not adequately address this challenge. Here, we discuss the pathophysiology of hypothermia in the newborn, its prevention and therapeutic options with particular attention to resource-limited environments. Newborns are equipped with sophisticated mechanisms of body temperature regulation. Neonatal thermoregulation is a critical function for newborn survival, regulated in the hypothalamus and mediated by endocrine pathways. Hypothermia activates cellular metabolism through shivering and nonshivering thermogenesis. In newborns, optimal temperature ranges are narrow and thermoregulatory mechanisms easily overwhelmed, particularly in premature and low-birth weight infants. Hyperthermia most commonly is associated with dehydration and potentially sepsis. The lack of thermal protection promptly leads to hypothermia, which is associated with detrimental metabolic and other pathophysiological processes. Simple thermal protection strategies are feasible at community and institutional levels in resource-limited environments. Appropriate interventions include skin-to-skin care, breastfeeding and protective clothing or devices. Due to poor provider training and limited awareness of the problem, appropriate thermal care of the newborn is often neglected in many settings. Education and appropriate devices might foster improved hypothermia management through mothers, birth attendants and health care workers. Integration of relatively simple thermal protection interventions into existing mother and child health programs can effectively prevent newborn hypothermia even in resource-limited environments.

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Head insulation and heat loss in the newborn.

Cited by 72 publications

References 12 publications

Respiratory Metabolism in Preterm Infants: the Measurement of Oxygen Consumpton during Prolonged Periods

Respiratory Metabolism in Preterm Infants: the Measurement of Oxygen Consumpton during Prolonged Periods

Decreasing Hypothermia During Delivery Room Stabilization of Preterm Neonates

Thermal protection of the newborn in resource-limited environments

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