Neonatal hypothermia

Abstract

Management of the thermal needs of the preterm infant at delivery through to admission to the neonatal unit remains a challenge to all health professionals involved in the care of the neonate. Despite advances in the understanding of methods of heat loss all to often neonates are subjected to becoming exposed to hypothermia. Hypothermia can have a significant effect on the infants health status which can lead to, decreased surfactant production, increased oxygen consumption and depletion of calorie reserves [Bailey, J., Rose, P., 2000. Temperature measurement in the preterm infant: a literature review. Journal of Neonatal Nursing 6 (1), 28e32]. Health professionals have a responsibility to be aware of and to ensure that the thermoregulatory needs of the infant are upheld in order to provide them with the best start possible. The article provides a detailed analysis of the importance of thermoregulation within the pre-term infant with particular reference to a case study identified within my practice as a neonatal nurse. Methods of heat loss are identified alongside positive changes to future practice.

Thermal protection of the newborn in resource-limited environments

“…18 Although a rectal digital thermometer is used in many studies as standard method to measure a newborn's core temperature, this measurement site is associated not only with discomfort and disturbance to the newborn, but also with risks such as rectal perforation and vagal stimulation with resulting arrhythmias, bradycardia and apnea. 42 The axilla is a less invasive, alternative site that provides reasonably accurate measurements. Mercury-in-glass, gallium-inglass, digital thermometer, analogous electric thermometer, chemical thermometer and infrared thermometer are all accurate instrument options, with the latter being less hazardous and quicker than the former.…”

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.…”

“…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. Heat loss from radiation involves heat loss to other objects not in direct contact, and evaporative heat loss occurs when fluid evaporates from wet skin into the air (Ellis, 2005).…”

“…When neonates are provided with sufficient thermal support they burn less energy (Thomas, 2003), have a lower oxygen requirement (Ellis, 2005) and have improved growth.…”

“…To assist in this task a skin probe was in position on his abdomen to give a constant reading of his temperature. Lyon (2004) maintains that a preterm baby who is comfortable will have a temperature of 36.8e37.3 C when measured by a skin probe, and Ellis (2005) explains that a core temperature of between 36.5 and 37.0 C is acceptable in balancing heat production and heat loss. The range of 36.5e37.0 C is supported by Martin and Kline (2004).…”