Interventions to prevent hypothermia at birth in preterm and/or low birthweight babies

Abstract

We report on a patient with the skeletal findings of Jackson‐Weiss syndrome, who manifests only mild craniofacial anomalies. Molecular analysis of her fibroblast growth factor receptor 1 gene (FGFR1) identified a heterozygous P252R missense mutation, previously only reported with FGFR1‐Pfeiffer syndrome like manifestations. Mutations in the immunoglobulin‐like, II–III (IgII–III) linker region of FGFR1 and FGFR3 molecules may present as a skeletal dysplasia affecting the appendicular skeleton including, brachydactyly, short broad middle phalanges, phalangeal epiphyseal coning and broad halluces. This communication is a further example of the phenomenon of an activated FGFR molecule resulting in overlapping manifestations in FGFR syndromes. Am. J. Med. Genet. 93:22–28, 2000. © 2000 Wiley‐Liss, Inc.

Neonatal thermal care: A discussion of two incubator modes for optimising thermoregulation. A care study

“…Heat can be lost in four different ways: conduction, convection, radiation and evaporation. These are documented by many different authors including Laroia et al (2008), Ellis (2005), Mellien (2001), Martin and Kline (2004), Cinar and Filiz (2006), WHO (1997WHO ( , 2010 and McCall et al (2010). Heat is lost by conduction when the skin is in direct contact with a cooler surface; convection involves heat loss from the infant to cold air.…”

“…The incubator then adjusts the amount of heat and therefore incubator temperatures to maintain the set level (Lyon, 2004;Martin and Kline, 2004). Lyon (2004), Sinclair and Sinn (2007) and McCall et al (2010) also emphasise the importance of humidity which should be added to the incubator to minimise transepidermal water loss. This aspect of care, although a very important part of temperature management is not going to be examined here but should always be considered.…”

Resuscitation of the newborn

“…Covering the preterm baby to the neck in food-grade plastic wrap or bag without drying under a radiant warmer has been shown to help keep them warm and thus enhances outcome. 8 These babies may respond to lower inflation pressures but may need more than room air to achieve appropriate oxygen saturations. Visible chest inflation can be an unreliable indicator of lung recruitment.…”

Neonatal thermoregulation

“…Methods to keep these high-risk babies warm include kangaroo-mother care (skin-to-skin contact) (Ludington-Hoe et al, 2000;Christidis et al, 2003;Dodd, 2005;McCall et al, 2005;Cramer et al, 2005), heated water-filled mattresses (Green-Abate et al, 1994;Gray and Flenady, 2003;Gray et al, 2004;McCall et al, 2005), radiant heaters (Baumgart et al, 1981;Bell, 1983;Bell and Rios, 1983;Seguin and Vieth, 1996;Flenady and Woodgate, 2003;Christidis et al, 2003), and incubators (McCall et al, 2005). More recent studies have demonstrated the effectiveness of occlusive polyethylene wrap to improve admission temperatures and reduce insensible losses in premature infants (Knauth et al, 1989;Vohra et al, 1999Vohra et al, , 2004Bjorklund and Hellstrom-Westas, 2000;Bredemeyer et al, 2005).…”

“…In their systematic review McCall et al (2005) conclude that, plastic wraps or bags, skin-to-skin care and transwarmer mattresses all keep preterm infants warmer, leading to higher temperatures on admission to neonatal units and less hypothermia. Given the low numbers needed to treat, consideration should be given to using these interventions in the delivery suite.…”