Neonatal thermoregulation

Abstract

Thermoregulation is the ability to balance between heat production and heat loss in order to maintain body temperature within a certain normal range. The provision of a thermoneutral environment is an essential component of the immediate and longer term care of newborn infants. Cold stress and hyperthermia may have serious metabolic consequences for all newborns. In the preterm these consequences may be devastating and may increase both morbidity and mortality rates. 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. Current medical literature lacks well designed, prospective, randomized controlled trials for both diagnosis and intervention of providing thermoneutral environment and systematic reviews report that none of the interventions have serious adverse effects.

Tub Bathing Improves Thermoregulation of the Late Preterm Infant

“…In addition, less adipose tissue and brown fat results in a decreased ability to maintain body temperature when challenged by cold stresses such as wet skin or a cool environment. There are two mechanisms by which term infants generate and conserve heat to counteract cold stress: nonshivering thermogenesis, which is the utilization of brown fat to generate heat and flexion of the arms and legs, which reduces the amount of surface area exposed to the air (Cinar & Filiz, 2006;Knobel & Holditch-Davis, 2007). Late preterm infants have less brown fat and often have less body tone for flexion.…”

Surgery and magnetic resonance imaging increase the risk of hypothermia in infants

“…Neonates are at particular risk of unintentional hypothermia, which is associated with significant harmful consequences, leading to increased morbidity and mortality . Accordingly, thermoregulatory management has long been a central tenet of neonatal intensive care, with a myriad of solutions available.…”

Effect of the use of a polyethylene wrap on the morbidity and mortality of very low birth weight infants in Alexandria University Children’s Hospital

“…If cold stress continues, glomerular filtration decreases, and fluid balance is further complicated by poor gastrointestinal absorption and decreased peristalsis. This renal impairment may finally lead to renal failure [23].…”