Neutral Temperature Range and Range of “Thermal Comfort” in Premature Infants

Brueck, K; Ah, Parmelee; Brueck, M

doi:10.1159/000239824

Cited by 112 publications

(51 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The infant's VOz and VC02 is obtained by the difference of O2 and C 0 2 fractions measured at the inlet and the outlet. From these data and total urinary N, energy expenditure is computed on the basis of oxygen volumes required to oxidize CHO, lipid, and protein (equations [9][10][11][12]. During calorimetry the activity state of each infant was monitored minute by minute using the scale developed by Briick el al.…”

Section: Methodsmentioning

confidence: 99%

“…During calorimetry the activity state of each infant was monitored minute by minute using the scale developed by Briick el al. (10) and simultaneously by a simplified activity scale ( Table 2). The assessments were performed by the same investigator.…”

Section: Methodsmentioning

confidence: 99%

“…Although several methods have been developed to score changes in spontaneous physical activity of infants (7,(9)(10)(11)(12)(13)(14)(15)(16), it is not known to what extent these scores are related to the rate of energy expenditure. Because the thermogenic response itself can be influenced by several factors such as duration of measurement, feeding frequency, size and type of test meal, the published measurements give variable results (9,12,(17)(18)(19)(20).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

et al. 1986

View full text Add to dashboard Cite

ABSTRACT. In order to assess the contribution of the thermogenic effect of feeding and muscular activity to total energy expenditure, nine premature infants were studied for 2 consecutive days during which time repeated measurements of energy expenditure by indirect calorimetry were performed throughout the day, combined with a visual activity score based on body movement. The infants were growing at 16.6 f 4.0 g/kg/day (mean f SD) and received 110 + 8 kcal/kg/day metabolizable energy (milk formula) and 522 + 40 mg N/kg/day. Their total energy expenditure was 68 f 4 kcal/kg/day indicating that 41 2 7 kcal/kg/day was retained for growth. Based on the combination of energy + N balances it was estimated that 80% of the weight gain was fat-free tissue and 20% was fat tissue. The rate of energy expenditure measured minute-by-minute was significantly and linearly correlated with the activity score in both the premeal ( r = 0.75; p < 0.001) and the postmeal periods ( r = 0.74; p < 0.001) with no difference in the regression slope, but with a significant difference in intercept. In preset feeding schedules the latter allowed an estimation of the thermogenic effect without the confounding effect of activity. This was found to be 3.1 + 1.8% when expressed as a percentage of metabolizable energy intake. However when the "classical" approach was used as a comparison (integretation of extra energy expenditure induced by the meal), the thermogenic effect was found to be greater, i.e. 9.5 + 3.8% of the meal's metabolizable energy, due to the superimposed effect of physical activity in the postprandial state. The study suggests that the intradaily variation in energy expenditure in premature infants nursed according to present day techniques is almost equally due to the thermogenic effect of feeding (3.2 kcal/kg/day), and to variations in muscular activity (3.6 kcal/kg/day) both representing a small fraction of the total energy expenditure in premature infants (i.e. 4.7 and 5.3%, respectively). This work was supported by a research grant from NestlC, Vevey Switzerland. 6ing and feeding, the study of energy metabolism in preterm infants has progressed at a rapid pace. However, measurements of energy expenditure in premature babies have been generally of short duration (5, 7-9), i.e. approximately 1-3 h. Therefore the extent to which these limited periods of measurement can be extrapolated to 24 h is still uncertain. When energy expenditure of preterm infants is continuously monitored over 24 h (6), the variability of measurements generally observed is mainly due to two factors: variations in physical activity (i.e. whole body movements, crying), and the thermogenic response to feeding. Although several methods have been developed to score changes in spontaneous physical activity of infants (7, 9-16), it is not known to what extent these scores are related to the rate of energy expenditure. Because the thermogenic response itself can be influenced by several factors such as duration of measurement, feeding frequency, size and typ...

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

et al. 1986

View full text Add to dashboard Cite

show abstract

“…20,21 Such a modification has never been reported after warm exposure, which is usually considered to be less disruptive than cool exposure. 22,23 Only mild thermal influences (similar to those encountered during standard nursing procedures) were considered, in order to avoid over-complex responses.…”

Section: Experimental Designmentioning

confidence: 99%

Influence of Thermal Drive on Central Sleep Apnea in the Preterm Neonate

Tourneux

Cardot

Museux

et al. 2008

Sleep

View full text Add to dashboard Cite

549 IN NEONATES, THE INCIDENCE OF APNEA DEPENDS ON A VARIETY OF FACTORS, SUCH AS BIRTH WEIGHT, 1 SEX, 2 GESTATIONAL AGE, 3 AND POSTNATAL AGE. 3,4 Central apnea is generally reported as occurring more frequently during active sleep than during quiet sleep. 2,3,[5][6][7] Many authors have pointed out that apnea incidence is also closely related to ambient temperature in both full-term [8][9][10] and preterm neonates 9,11,12 and that the rate of apneic events is increased by warm exposure (i.e., thermal drive). Although preterm neonates are more often exposed to cool stress than to warm stress, little is known about the influence of cool exposure on the incidence of apnea in the different sleep states. Bader et al 11 reported a lower rate of central apnea during transient decreases in incubator temperature from warm (29°C) to thermoneutral conditions (24°C) over 30 minutes, although this was only seen during quiet sleep for preterm infants and during active sleep for term infants.The mechanism linking thermal stress and apnea is unknown and thus warrants further investigation. On the basis of the above-cited studies, it can be supposed that suprapontine influences modify respiratory control, which must be considered as a multiple-interaction system. Abnormal functional interaction among the respiratory system, thermoregulatory system, and sleep processes may alter compensatory responses to autonomic cardiovascular or respiratory challenge and increase the likelihood of life-threatening events later in life. 13 The effect of thermal stress is usually assessed by monitoring the body's internal temperature (generally esophageal or rectal temperatures, which supposedly represent the core temperature) and/or mean skin temperature. 14 However, the central controller of the thermoregulatory system receives thermal inputs from thermosensitive structures distributed throughout the body. The regulated variable therefore results from a weighted sum of different body temperatures. 15 Hence, to fully understand the thermal influence on apnea incidence in cool environments, it is essential to quantify the magnitude of body cooling that is proportional to the radiant, convective, conductive, and evaporative heat losses (i.e., body heat loss) on the other. Any failure to maintain thermal balance stimulates the body's thermal control mechanisms and thus triggers regulatory adjustments. This approach may help clarify a hypothesis raised by Perlstein et al, 9 whereby apnea is not specifically induced by changes in air temperature but, rather, through processes controlling the overall body heat loss (BHL). Hence, in the present study, the role of thermal drive in the mechanisms underlying the genesis of central apnea in the sleeping neonate was assessed by taking into account BHL during mild warm and cool thermal exposures.Central apneic events were monitored in a group of 22 nearterm neonates. Indeed, there are few published studies on these infants, who are generally considered to be physiologically similar to term infants, even t...

show abstract

“…This is defined äs the temperature at which the basal metabolism, particularly oxygen consumption, is at its lowest [8], According to investigations of HEY and KATZ [27] in which birth weight and age were taken into consideration, the neutral temperature of prematures is in excess of 34°C…”

Section: Neutral Temperaturementioning

confidence: 99%

The necessity for thermal prophylaxis in the neonate

Schachinger¹,

Ballowitz²,

Frank³

1974

Journal of Perinatal Medicine

View full text Add to dashboard Cite

The admission of hypothermic newborn and especially premature infants continues to be an everyday problem in pediatric intensive care units [21,22,33,34]. The principal reason is the lack of consideration for the mechanisms and dangers of heat loss for newborns immediately after birth. The causes of heat lossThe mechanisms of heat loss are determined by the special factors of body proportions and by environmental factors. The loss of heat to the environment occurs by conduction, convection, radiation and evaporation. The basic physical laws include the following relevant factors: air temperature (the temperature difference between body and environment), air humidity (the vapor pressure of the skin is greater than that of the air), air speed, wall temperature, the radius of the body, and the ratio of surface to volume of this body. The surface/volume ratio is considerably greater in the premature and newborn than in the adult (Tab. I). The resulting increase in heat loss is enhanced by the lower insulation of the thin subcutaneous layer of fat. The proportion of the body surface exposed to the environment is 50-80% of the anatomical surface depending on the posture [24]. For intubated patients an additional consideration is the fact that 10% of the total heat loss occurs through the internal surface of the respiratory System [24], Curriculum vitae

show abstract

Neutral Temperature Range and Range of “Thermal Comfort” in Premature Infants

Cited by 112 publications

References 2 publications

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

Energy Balance, Physical Activity, and Thermogenic Effect of Feeding in Premature Infants

Influence of Thermal Drive on Central Sleep Apnea in the Preterm Neonate

The necessity for thermal prophylaxis in the neonate

Contact Info

Product

Resources

About