Transitory hypothermia as early prognostic factor in term newborns with intrauterine growth retardation

Lazic-Mitrovic, Tanja; Djukic, Milan; Cutura, Nedjo; Andjelic, Spaso; Curkovic, Aleksandar; Soldo, Vesna; Radlovic, Nedeljko

doi:10.2298/sarh1010604l

Cited by 9 publications

(3 citation statements)

References 11 publications

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“…Preterm infants are especially vulnerable. Hypothermia is also associated with serious morbidities, such as increased risk of IVH, 19,26,39,[50][51][52][53][54] respiratory issues, 15,19,21,50,[55][56][57][58][59][60] hypoglycemia, 15,44,[60][61][62][63][64] and late-onset sepsis. 33,65 Because of this, admission temperature should be recorded as a predictor of outcomes as well as a quality indicator (Class I, LOE B-NR.)…”

Section: Importance Of Maintaining Normal Temperature In the Deliverymentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Circulation

615

344

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Section: Importance Of Maintaining Normal Temperature In the Deliverymentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Circulation

615

344

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“…29 The association between hypothermia and mortality has been known for more than a century, 30 and the admission temperature of newborn non-asphyxiated infants is a strong predictor of mortality at all gestations and in all settings. Preterm infants are especially vulnerable and hypothermia is also associated with serious morbidities such as intraventricular haemorrhage 35,42,55,[66][67][68][69] need for respiratory support 31,35,37,66,[70][71][72][73][74] hypoglycaemia 31,49,60,[74][75][76][77][78][79] and in some studies late onset sepsis. 49 The temperature of newly born non-asphyxiated infants should be maintained between 36.5 • C and 37.5 • C after birth.…”

Section: Temperature Controlmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

Bruinenberg²,

et al. 2015

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“…43,60 For the serious outcome of hypoglycemia, there were seven observational studies (very-low-quality, downgraded for risk of bias and indirectness) showing a significant association between hypothermia (less than 36°C) and hypoglycemia. 44,67,70,[97][98][99][100] Two of these studies, using historical controls, showed improved glycemic control with improved normothermia. 44,99 For the serious outcome of late sepsis, 2 observational studies (very-low-quality evidence, downgraded for risk of bias and indirectness) indicated an association between hypothermia on admission and late sepsis.…”

mentioning

confidence: 99%

Part 7: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2015

Circulation

534

256

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The transition from intrauterine to extrauterine life that occurs at the time of birth requires timely anatomic and physiologic adjustments to achieve the conversion from placental gas exchange to pulmonary respiration. This transition is brought about by initiation of air breathing and cessation of the placental circulation. Air breathing initiates marked relaxation of pulmonary vascular resistance, with considerable increase in pulmonary blood flow and increased return of now-welloxygenated blood to the left atrium and left ventricle, as well as increased left ventricular output. Removal of the lowresistance placental circuit will increase systemic vascular resistance and blood pressure and reduce right-to-left shunting across the ductus arteriosus. The systemic organs must equally and quickly adjust to the dramatic increase in blood pressure and oxygen exposure. Similarly, intrauterine thermostability must be replaced by neonatal thermoregulation with its inherent increase in oxygen consumption.Approximately 85% of babies born at term will initiate spontaneous respirations within 10 to 30 seconds of birth, an additional 10% will respond during drying and stimulation, approximately 3% will initiate respirations after positive-pressure ventilation (PPV), 2% will be intubated to support respiratory function, and 0.1% will require chest compressions and/or epinephrine to achieve this transition. [1][2][3] Although the vast majority of newborn infants do not require intervention to make these transitional changes, the large number of births worldwide means that many infants require some assistance to achieve cardiorespiratory stability each year.Newly born infants who are breathing or crying and have good tone immediately after birth must be dried and kept warm so as to avoid hypothermia. These actions can be provided with the baby lying on the mother's chest and should not require separation of mother and baby. This does not preclude the need for clinical assessment of the baby. For the approximately 5% of newly born infants who do not initiate respiratory effort after stimulation by drying, and providing warmth to avoid hypothermia, 1 or more of the following actions should be undertaken: providing effective ventilation with a face mask or endotracheal intubation, and administration of chest compressions with or without intravenous medications or volume expansion for those with a persistent heart rate less than 60/min or asystole, despite strategies to achieve effective ventilation (Figure 1).The 2 vital signs that are used to identify the need for an intervention as well as to assess the response to interventions are heart rate and respirations. Progression down the algorithm should proceed only after successful completion of each step, the most critical being effective ventilation. A period of only approximately 60 seconds after birth is allotted to complete each of the first 2 steps, ie, determination of heart rate and institution of effective ventilation. Subsequent progression to the next step will depend o...

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Transitory hypothermia as early prognostic factor in term newborns with intrauterine growth retardation

Abstract: Transitory hypothermia in the first ten hours of life represents a significant risk factor for deepening hypoglycaemia, asphyxia, hyperbilirubinaemia and hypocalcaemia in term newborns with IUGR.

Cited by 9 publications

References 11 publications

Part 13: Neonatal Resuscitation

Part 13: Neonatal Resuscitation

European Resuscitation Council Guidelines for Resuscitation 2015

Part 7: Neonatal Resuscitation

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