Fatores de risco e morbimortalidade associada à hipotermia à admissão na unidade de terapia intensiva neonatal

Abstract

OBJECTIVE: To determine the incidence of hypothermia, risk factors and outcomes associated with lower temperature on admission to the neonatal intensive care unit in very low birth weight infants. METHODS: Longitudinal, observational, prospective study. Very low birth weight infants admitted to the neonatal intensive care unit between October/2017 to September/2018 were included. The dependent variable was axillary temperature at admission. Hypothermia incidence was calculated and temperature averages were compared for the risk factors and outcomes evaluated. Statistical tests: measures of central tendency, relative/absolute frequencies, Kolmogorov-Smirnov test, Levene and Students t test, considering significant p<0.05. RESULTS: 128 very low birth weight newborns, with average weight and gestational age, respectively, 1,079.2 g and 29 weeks, were included. Of these, 110 (85.9%) had moderate hypothermia, 13 (10.2%) mild hypothermia and only 5 (3.9%) were normothermic on admission. The average temperature found was 34.7°C. The following risk factors maintained an association with lower temperature at admission: weight and gestational age, Apgar index and neonatal resuscitation. The associated outcomes were: respiratory distress syndrome, use of mechanical ventilation and vasoactive drugs, pulmonary hemorrhage, use of oxygen at 28 days of life, delayed sepsis, and death. CONCLUSION: The incidence of hypothermia found was high and the lower temperature at admission was associated with higher morbidity and mortality. Care in care practices is necessary to maintain the temperature of very low birth weight newborns, especially those of lower weight and gestational age and who require neonatal resuscitation.