Reducing hypothermia in preterm infants with polyethylene wrap

Rohana, J; Khairina, Wan Mohd Nowalid Wan; Ny, Boo; Ishak, Shareena

doi:10.1111/j.1442-200x.2010.03295.x

Cited by 51 publications

(61 citation statements)

References 14 publications

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“…As shown in trials of preterm very low birth weight and low birth weight infants, 10,17,18 there was a positive correlation between birth weight and temperature at 1 hour after birth, but the correlation was weaker in the intervention group, suggesting that the plastic bag has a greater effect on infants with a lower birth weight. Even neonates who were normothermic at 15 minutes after birth benefited from the plastic bags by developing a lower rate of moderate hypothermia and smaller decreases in axillary temperature over the first hour after birth.…”

Section: Discussionmentioning

confidence: 98%

“…15,16 Randomized trials of plastic bag use during the first hour after birth in larger preterm infants showed decreased rates of hypothermia. [17][18][19] It is possible that the addition of the plastic bag to standard WHO thermoregulation care may be an effective intervention to decrease rates of hypothermia in term neonates. The current trial sought to determine if placing term infants in polyethylene plastic bags at birth reduces hypothermia 1 hour after birth.…”

Section: Resultsmentioning

confidence: 99%

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Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Term neonates in resourcepoor settings frequently develop hypothermia. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants. WHAT THIS STUDY ADDS:For term neonates born in a resourcepoor health facility, placement in a plastic bag at birth can reduce the incidence of hypothermia at 1 hour after birth. abstract OBJECTIVES: Term infants in resource-poor settings frequently develop hypothermia during the first hours after birth. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants. Our objective was to test the hypothesis that placement of term neonates in plastic bags at birth reduces hypothermia at 1 hour after birth in a resource-poor hospital.METHODS: This parallel-group randomized controlled trial was conducted at University Teaching Hospital, the tertiary referral center in Zambia. Inborn neonates with both a gestational age $37 weeks and a birth weight $2500 g were randomized 1:1 to either a standard thermoregulation protocol or to a standard thermoregulation protocol with placement of the torso and lower extremities inside a plastic bag within 10 minutes after birth. The primary outcome was hypothermia (,36.5°C axillary temperature) at 1 hour after birth. RESULTS:Neonates randomized to plastic bag (n = 135) or to standard thermoregulation care (n = 136) had similar baseline characteristics (birth weight, gestational age, gender, and baseline temperature). Neonates in the plastic bag group had a lower rate of hypothermia (60% vs 73%, risk ratio 0.76, confidence interval 0.60-0.96, P = .026) and a higher axillary temperature (36.4 6 0.5°C vs 36.2 6 0.7°C, P , .001) at 1 hour after birth compared with infants receiving standard care.CONCLUSIONS: Placement in a plastic bag at birth reduced the incidence of hypothermia at 1 hour after birth in term neonates born in a resource-poor setting, but most neonates remained hypothermic.

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Section: Discussionmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

et al. 2013

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“…Additionally, evidence that suggests plastic wrap coverings reduce the risk of intraventricular hemorrhage is statistically insignificant [20,25,26]. Moreover, past findings reveal that plastic wraps do not completely decrease the risk of respiratory distress syndrome [20]. Further studies to investigate the impact of plastic wraps on neonatal morbidity and mortality are warranted.…”

Section: Polyethylene Occlusive Wrapmentioning

confidence: 99%

“…There are a large number of proofs or past incidents that swaddling preterm neonates with plastic bag immediately after birth reduces heat loss and is as effective as standard thermoregulation procedures [18][19][20]. Yet, it doesn't reduce heat loss in neonates aged 28 to 31 weeks [21].…”

Section: Polyethylene Occlusive Wrapmentioning

confidence: 99%

“…Four randomized controlled trials concluded that hyperthermia isn't associated with plastic covering, while other studies that investigated the effect of plastic wrap among other procedures as a thermoregulatory bundle in VLBW indicated that there is no increase in hyperthermia rates with the use of polyethylene wraps. Similarly, clinical trial that has been conducted on 96 neonates aged 29-32 weeks found that there is no risk of hyperthermia with plastic bags [19][20][21][22][23][24][25][26][27][28][29].…”

Section: Polyethylene Occlusive Wrapmentioning

confidence: 99%

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The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

El-Atawi¹

2018

JPNC

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Preterm neonates are more vulnerable to many diseases and complications than full-term infants as most of their biological systems are still underdeveloped. Fortunately, most of these morbidities are preventable as there are many interventions that could be performed in the first 60 minutes of neonatal life to avoid them and their long-term consequences, thus rightfully defining 'the golden hour'. The objective of this article is to review the potential morbidities that neonates might experience and understand their mechanisms, risk factors and its possible outcomes. We also reviewed the possible actions that could be implemented during the golden hour to prevent these morbidities and investigated their effectiveness. Medline and Cochrane database for systematic review were the main two electronic database that we used to search for studies. Studies pertaining to morbidities, such as hypothermia, hypoglycemia, respiratory distress, intraventricular hemorrhage (IVH), Chronic lung disease (CLD) and retinopathy of prematurity (ROP) have been selected according to their full text accessibility for us. Reports related to possible interventions that could be performed to prevent these morbidities have also been involved that include but not only restricted to drying & head coverings, polyethylene occlusive skin wraps, ambient room temperature, pre-warmed incubator, heated humidified gases, heated mattress and skin-to-skin contact for hypothermia; dextrose infusion pump, dextrose burette and oral dextrose for hypoglycemia; indomethacin, ibuprofen, antithrombin and heparin for IVH; surfactant and CPAP for respiratory distress; controlling oxygen saturation for ROP. Keywords: The First Sixty Minutes in Preterm Neonates' Life: Predicted Morbidities and Interventions 2/8Copyright: ©2018 El-Atawi et al. the relation between severe hypothermia (<32°C) and shortand long-term neurodevelopmental outcomes are required. Moderate hypothermia was found to be associated with severe intraventricular hemorrhage, intraventricular leukomalacia, and necrotizing enterocolitis. Yet, these associations should be analyzed carefully since they were based on studies with a wide confidence interval. More studies with larger sample size are warranted to accurately illustrate these associations [5]. Moreover, hypothermia increases oxygen consumption, thus leading to hypoxia and subsequently pulmonary vasoconstriction which, in turn, declines surfactant production and worsens respiratory distress. The presence of comorbidities with hypothermia increases the fatality rate, so adding a higher category to the severity of hypothermia would represent an effective addition to the WHO classification of the severity of hypothermia [8].Large surface area of neonates in relation to their small body weight makes them more vulnerable to hypothermia than fullterm babies. Preterm neonates have a higher transepidermal water loss than term due to their immature epidermal layer [9]. Their premature vasomotor control which acts as a thermoregulatory mec...

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Delivery Room Interventions for Hypothermia in Preterm Neonates

et al. 2021

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IMPORTANCE Prevention of hypothermia in the delivery room is a cost-effective, high-impact intervention to reduce neonatal mortality, especially in preterm neonates. Several interventions for preventing hypothermia in the delivery room exist, of which the most beneficial is currently unknown. OBJECTIVE To identify the delivery room thermal care intervention that can best reduce neonatal hypothermia and improve clinical outcomes for preterm neonates born at 36 weeks' gestation or less.DATA SOURCES MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, and CINAHL databases were searched from inception to November 5, 2020.STUDY SELECTION Randomized and quasi-randomized clinical trials of thermal care interventions in the delivery room for preterm neonates were included. Peer-reviewed abstracts and studies published in non-English language were also included.DATA EXTRACTION AND SYNTHESIS Data from the included trials were extracted in duplicate using a structured proforma. A network meta-analysis with bayesian random-effects model was used for data synthesis.MAIN OUTCOMES AND MEASURES Primary outcomes were core body temperature and incidence of moderate to severe hypothermia on admission or within the first 2 hours of life. Secondary outcomes were incidence of hyperthermia, major brain injury, and mortality before discharge. The 9 thermal interventions evaluated were (1) plastic bag or plastic wrap covering the torso and limbs with the head uncovered or covered with a cloth cap; (2) plastic cap covering the head; (3) skin-to-skin contact; (4) thermal mattress; (5) plastic bag or plastic wrap with a plastic cap; (6) plastic bag or plastic wrap along with use of a thermal mattress; (7) plastic bag or plastic wrap along with heated humidified gas for resuscitation or for initiating respiratory support in the delivery room; (8) plastic bag or plastic wrap along with an incubator for transporting from the delivery room; and (9) routine care, including drying and covering the body with warm blankets, with or without a cloth cap. RESULTSOf the 6154 titles and abstracts screened, 34 studies that enrolled 3688 neonates were analyzed. Compared with routine care alone, plastic bag or wrap with a thermal mattress (mean difference [MD], 0.98 °C; 95% credible interval [CrI], 0.60-1.36 °C), plastic cap (MD, 0.83 °C; 95% CrI, 0.28-1.38 °C), plastic bag or wrap with heated humidified respiratory gas (MD, 0.76 °C; 95% CrI, 0.38-1.15 °C), plastic bag or wrap with a plastic cap (MD, 0.62 °C; 95% CrI, 0.37-0.88 °C), thermal mattress (MD, 0.62 °C; 95% CrI, 0.33-0.93 °C), and plastic bag or wrap (MD, 0.56 °C; 95% CrI, 0.44-0.69 °C) were associated with greater core body temperature. Certainty of evidence was moderate for 5 interventions and low for plastic bag or wrap with a thermal mattress. When compared with routine care alone, a plastic bag or wrap with heated humidified respiratory gas was associated with less risk of major brain injury (risk ratio, 0.23; 95% CrI, 0.03-0.67; moderate certainty of evidence) and a plastic ...

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Reducing hypothermia in preterm infants with polyethylene wrap

Abstract: Wrapping premature infants with gestational age <34 weeks in polyethylene plastics immediately after birth is associated with lower incidence of hypothermia.

Cited by 51 publications

References 14 publications

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

Randomized Trial of Plastic Bags to Prevent Term Neonatal Hypothermia in a Resource-Poor Setting

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

Delivery Room Interventions for Hypothermia in Preterm Neonates

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