Efficacy of Polyethylene Skin Wrapping in Preventing Hypothermia in Preterm Neonates (&lt;34 Weeks): A Parallel Group Non-blinded Randomized Control Trial

Nimbalkar, Somashekhar; Khanna, Ankush; Patel, Dipak V.; Nimbalkar, Archana; Phatak, Ajay

doi:10.1093/tropej/fmy025

Cited by 12 publications

(21 citation statements)

References 22 publications

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“…The results of a randomised clinical trial with 801 infants were similar for extremely preterm infants born between 24 and 27 weeks of gestation: preterm infants in the polyethylene bag group had a higher mean body temperature on admission, although the intergroup difference in the mortality rate was not statistically significant 30 . Other randomised clinical trials found similar results: the use of a polyethylene bag on admission was associated with a higher body temperature in preterm infants with a gestational age below 34 weeks of gestation in one trial 31 and below 30 weeks of gestation in another 32 …”

Section: Resultsmentioning

confidence: 79%

Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society

et al. 2022

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Aim Thermal instability is harmful on the newborn infant. We sought to draw up practical guidelines on maintaining homeothermy alongside skin‐to‐skin contact. Methods A systematic analysis of the literature identified relevant studies between 2000 and 2021 in the PubMed database. Selected publications were evaluated, and their level of evidence was graded, in order to underpin the development of clinical guidelines. Results We identified 7 meta‐analyses and 64 clinical studies with a focus on newborn infants homeothermy. Skin‐to‐skin contact is the easiest and most rapidly implementable method to prevent body heat loss. Alongside skin‐to‐skin contact, monitoring the newborn infant's body temperature with a target of 37.0°C is essential. For newborn infants <32 weeks of gestation, a skullcap and a polyethylene bag should be used in the delivery room or during transport. To limit water loss, inhaled gases humidification and warming is recommended, and preterm infants weighing less than 1600 g should be nursed in a closed, convective incubator. With regard to incubators, there are no clear benefits for single‐ versus double‐wall incubators as well as for air versus skin servo control. Conclusion Alongside skin‐to‐skin contact, a bundle of practical guidelines could improve the maintenance of homeothermy in the newborn infant.

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Section: Resultsmentioning

confidence: 79%

Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society

et al. 2022

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“…in previous studies [3,13,[27][28][29][30][31][32]. However, the hypothermia rates after intervention were 8.6% in the DR and 15.5% on admission, which were both lower than those of other hospitals [27][28][29][30][33][34][35][36][37]. The discrepancy between these findings may be attributed to the fact that previous studies focused on single variables (e.g., to wrap or not, different wrapping materials,…”

Section: Plos Onementioning

confidence: 82%

Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia

Chiu

Chen

et al. 2022

PLoS ONE

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Introduction In very low birth weight (VLBW) infants, hypothermia immediately following birth is common even in countries rich in medical resources. The purpose of this study is to design a standard prevention bundle that decreases the rate of hypothermia among infants after birth and to investigate efficacy of the bundle and short-term outcomes for VLBW infants. Methods This quality improvement project was conducted from February 2017 to July 2018 on all VLBW preterm infants admitted at a single referral level III neonatal intensive care unit. The infants were classified into the pre-intervention (February to September 2017) and post-intervention (October 2017 to July 2018) groups according to the time periods when they were recruited. During the pre-intervention period, we analyzed the primary causes of hypothermia, developed solutions corresponding to each cause, integrated all solutions into a prevention bundle, and applied the bundle during the post-intervention period. Afterwards, the incidence of neonatal hypothermia and short-term outcomes, such as intraventricular hemorrhage (IVH), acidosis, and shock requiring inotropic agents, in each group were compared. Results A total of 95 VLBW infants were enrolled in the study, including 37 pre-intervention, and 58 post-intervention cases. The incidence of hypothermia in preterm infants decreased significantly upon the implementation of our prevention bundle, both in the delivery room (from 45.9% to 8.6%) and on admission (59.5% to 15.5%). In addition, the short-term outcomes of VLBW infants improved significantly, especially with the decreased incidence of IVH (from 21.6% to 5.2%, P = 0.015). Conclusions Our standardized prevention bundle for preventing hypothermia in VLBW infants is effective and decreased the IVH rate in VLBW infants. We strongly believe that this prevention bundle is a simple, low-cost, replicable, and effective tool that hospitals can adopt to improve VLBW infant outcomes.

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“…A total of 6154 titles and abstracts were screened, of which 34 studies that enrolled 3688 neonates were included (eFigure 1 in the Supplement). Among the 34 studies were 4 three-armed RCTs . The mean gestational age of the neonates was 29 weeks, and their mean birth weight was 1200 g (eFigures 2 and 3 in the Supplement).…”

Section: Resultsmentioning

confidence: 99%

Delivery Room Interventions for Hypothermia in Preterm Neonates

et al. 2021

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IMPORTANCE Prevention of hypothermia in the delivery room is a cost-effective, high-impact intervention to reduce neonatal mortality, especially in preterm neonates. Several interventions for preventing hypothermia in the delivery room exist, of which the most beneficial is currently unknown. OBJECTIVE To identify the delivery room thermal care intervention that can best reduce neonatal hypothermia and improve clinical outcomes for preterm neonates born at 36 weeks' gestation or less.DATA SOURCES MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and CINAHL databases were searched from inception to November 5, 2020.STUDY SELECTION Randomized and quasi-randomized clinical trials of thermal care interventions in the delivery room for preterm neonates were included. Peer-reviewed abstracts and studies published in non-English language were also included.DATA EXTRACTION AND SYNTHESIS Data from the included trials were extracted in duplicate using a structured proforma. A network meta-analysis with bayesian random-effects model was used for data synthesis.MAIN OUTCOMES AND MEASURES Primary outcomes were core body temperature and incidence of moderate to severe hypothermia on admission or within the first 2 hours of life. Secondary outcomes were incidence of hyperthermia, major brain injury, and mortality before discharge. The 9 thermal interventions evaluated were (1) plastic bag or plastic wrap covering the torso and limbs with the head uncovered or covered with a cloth cap; (2) plastic cap covering the head; (3) skin-to-skin contact; (4) thermal mattress; (5) plastic bag or plastic wrap with a plastic cap; (6) plastic bag or plastic wrap along with use of a thermal mattress; (7) plastic bag or plastic wrap along with heated humidified gas for resuscitation or for initiating respiratory support in the delivery room; (8) plastic bag or plastic wrap along with an incubator for transporting from the delivery room; and (9) routine care, including drying and covering the body with warm blankets, with or without a cloth cap. RESULTSOf the 6154 titles and abstracts screened, 34 studies that enrolled 3688 neonates were analyzed. Compared with routine care alone, plastic bag or wrap with a thermal mattress (mean difference [MD], 0.98 °C; 95% credible interval [CrI], 0.60-1.36 °C), plastic cap (MD, 0.83 °C; 95% CrI, 0.28-1.38 °C), plastic bag or wrap with heated humidified respiratory gas (MD, 0.76 °C; 95% CrI, 0.38-1.15 °C), plastic bag or wrap with a plastic cap (MD, 0.62 °C; 95% CrI, 0.37-0.88 °C), thermal mattress (MD, 0.62 °C; 95% CrI, 0.33-0.93 °C), and plastic bag or wrap (MD, 0.56 °C; 95% CrI, 0.44-0.69 °C) were associated with greater core body temperature. Certainty of evidence was moderate for 5 interventions and low for plastic bag or wrap with a thermal mattress. When compared with routine care alone, a plastic bag or wrap with heated humidified respiratory gas was associated with less risk of major brain injury (risk ratio, 0.23; 95% CrI, 0.03-0.67; moderate certainty of evidence) and a plastic ...

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Efficacy of Polyethylene Skin Wrapping in Preventing Hypothermia in Preterm Neonates (<34 Weeks): A Parallel Group Non-blinded Randomized Control Trial

Cited by 12 publications

References 22 publications

Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society

Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society

Reducing intraventricular hemorrhage following the implementation of a prevention bundle for neonatal hypothermia

Delivery Room Interventions for Hypothermia in Preterm Neonates

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