Heat Loss Prevention: A Systematic Review of Occlusive Skin Wrap for Premature Neonates

Cramer, Kristie; Wiebe, Natasha; Hartling, Lisa; Crumley, Ellen; Vohra, Sunita

doi:10.1038/sj.jp.7211392

Cited by 88 publications

(64 citation statements)

References 27 publications

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“…[9][10][11][12] Systematic reviews of randomized controlled trials and historical controlled trials found that occlusive skin wrapping at delivery increases NICU admission temperature and reduces hypothermia in preterm infants. 13,14 Plastic bags or wraps aid in thermal regulation by protecting infants from radiant, evaporative, and convective heat loss. 15,16 Randomized trials of plastic bag use during the first hour after birth in larger preterm infants showed decreased rates of hypothermia.…”

Section: Resultsmentioning

confidence: 99%

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Term neonates in resourcepoor settings frequently develop hypothermia. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants. WHAT THIS STUDY ADDS:For term neonates born in a resourcepoor health facility, placement in a plastic bag at birth can reduce the incidence of hypothermia at 1 hour after birth. abstract OBJECTIVES: Term infants in resource-poor settings frequently develop hypothermia during the first hours after birth. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants. Our objective was to test the hypothesis that placement of term neonates in plastic bags at birth reduces hypothermia at 1 hour after birth in a resource-poor hospital.METHODS: This parallel-group randomized controlled trial was conducted at University Teaching Hospital, the tertiary referral center in Zambia. Inborn neonates with both a gestational age $37 weeks and a birth weight $2500 g were randomized 1:1 to either a standard thermoregulation protocol or to a standard thermoregulation protocol with placement of the torso and lower extremities inside a plastic bag within 10 minutes after birth. The primary outcome was hypothermia (,36.5°C axillary temperature) at 1 hour after birth. RESULTS:Neonates randomized to plastic bag (n = 135) or to standard thermoregulation care (n = 136) had similar baseline characteristics (birth weight, gestational age, gender, and baseline temperature). Neonates in the plastic bag group had a lower rate of hypothermia (60% vs 73%, risk ratio 0.76, confidence interval 0.60-0.96, P = .026) and a higher axillary temperature (36.4 6 0.5°C vs 36.2 6 0.7°C, P , .001) at 1 hour after birth compared with infants receiving standard care.CONCLUSIONS: Placement in a plastic bag at birth reduced the incidence of hypothermia at 1 hour after birth in term neonates born in a resource-poor setting, but most neonates remained hypothermic.

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Section: Resultsmentioning

confidence: 99%

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

et al. 2013

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“…Vento et al 9 reported arterial blood gases obtained from the umbilical artery during resuscitation in a blinded and randomized trial. When infants were resuscitated with pure oxygen PaO 2 , levels were above 100 mm Hg at 5 to 6 min, at 15 min, and thereafter, whereas infants resuscitated with air did not exceed 80 11 Death within 7 days and/or moderate or severe hypoxic-ischemic encephalopathy, the primary outcome measure, was not significantly different. This study, which enrolled patients primarily from developing countries, reported that asphyxiated newborn infants can be resuscitated with air as efficiently as with 100% oxygen.…”

Section: Oxygen Use In the Drmentioning

confidence: 99%

“…In a meta-analysis of trials involving occlusive wraps, the same author found that wrapped infants were admitted with a significantly higher temperature but were not significantly less likely to die. 80 When used together, an occlusive wrap, a warm room and an efficient radiant warmer can combine to make an ELBW infant too warm. Therefore, close monitoring of temperature is recommended by both groups.…”

Section: Intubationmentioning

confidence: 99%

Neonatal resuscitation for the preterm infant: evidence versus practice

Finer

Rich

2010

J Perinatol

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In an effort to determine the actual conduct of neonatal resuscitation and the errors that may be occurring during this process, we developed a method of video recording neonatal resuscitations as an ongoing quality assurance project. We initiated video recordings of resuscitations using simple video recorders attached to an overhead warmer and reviewed the resultant tapes during biweekly quality improvement meetings. We also added the continuous recording of analog information such as heart rate, oximeter values, fraction of inspired oxygen and airway pressure. We subsequently developed a checklist that includes a preresuscitation briefing and a postresuscitation debriefing, all of which are reviewed at the same time as the video recording. We have examined the use of oxygen in the very preterm infant, the effectiveness of bag and mask ventilation, including the detection of airway obstruction during such ventilation, intubation in the delivery area and environment. In addition, we have trained our teams and leaders using Crew Resource Management and focused on improved communication. The availability of a dedicated room for resuscitation allows an increased ambient environment and the ability to provide a userfriendly setting similar to the neonatal intensive care unit to optimize performance. There are numerous opportunities for improving team and leader performance and outcomes following neonatal resuscitation. Further prospective studies are required to evaluate specific interventions.

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“…Consensus on Science A large body of evidence supports the wrapping of newborn infants of Ͻ28 weeks' gestation in polythene wraps or bags at birth without drying to reduce heat loss (LOE 1 121,122 ). Some of these infants were hyperthermic on admission to the neonatal intensive care unit, but it is unclear whether this is because they were born hot or be- …”

Section: Maintenance Of Body Temperature Nrp-023amentioning

confidence: 99%

Neonatal Resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2010

Pediatrics

527

634

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Heat Loss Prevention: A Systematic Review of Occlusive Skin Wrap for Premature Neonates

Abstract: The findings suggest that occlusive skin wrap prevents heat loss in premature infants. The meta-analysis lacked the power to provide definitive results regarding the effect of wrap on mortality.

Cited by 88 publications

References 27 publications

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

Neonatal resuscitation for the preterm infant: evidence versus practice

Neonatal Resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

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