Role of effective thermoregulation in premature neonates

Knobel-Dail, Robin B

doi:10.2147/rrn.s52377

Cited by 21 publications

(14 citation statements)

References 47 publications

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“…An under‐developed thermoregulatory system predisposes sick and preterm infants to increased hypothermic risk . For this reason, well‐supported evidence‐based thermal management practices exist in the NICU and these translate to high rates of normothermia in the NICU.…”

Section: Discussionmentioning

confidence: 99%

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

Paul

Perkins

Pereira‐Fantini

et al. 2018

J Paediatrics Child Health

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Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

Paul

Perkins

Pereira‐Fantini

et al. 2018

J Paediatrics Child Health

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“…Moreover, it isn't a handy device in resource-limited settings such as developing countries. The warm moist environment of the incubator represents an ideal media for bacteria to proliferate which increases the risk of staphylococcal infection [38]. A recent systematic review concluded that there is no risk of hyperthermia with synchronized use of incubators (5.4% with incubator use, 8.1% without, RR = 0.66; 95% CI 0.19 to 2.3) [24].…”

Section: Skin-to-skin Contact (Ssc)mentioning

confidence: 99%

“…Moreover, it isn't a handy device in resource-limited settings such as developing countries. The warm moist environment of the incubator represents an ideal media for bacteria to proliferate which increases the risk of staphylococcal infection [38] 6]., respectively; P < .0001) [39]. A randomized controlled trial that compared between HHG and cold dry gas concluded that in the HHG group, 69% of preterm neonates were normothermic compared with 55% in the cold, dry gas group (unadjusted OR 1.8, 95% CI 1.01-3.19) [40].…”

Section: Skin-to-skin Contact (Ssc)mentioning

confidence: 99%

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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“…Sabe-se que este é um problema particularmente relevante nos RNPT, com idade gestacional igual ou menor do que 30 semanas, durante a primeira semana de vida, nos quais a evaporação é elevada devido ao aumento da perda de água transepidérmica (2,3) . O cuidado quanto à temperatura corporal do recém-nascido deve iniciar desde o nascimento, ainda na sala de parto, estendendo-se para todos os ambientes e etapas de seu internamento.…”

Section: Introductionunclassified

Repercussões Do Uso De Incubadoras Umidificadas Na Regulação Térmica Do Prematuro: Uma Revisão Integrativa

2016

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Objetivo: analisar, em publicações científicas, as repercussões do uso de incubadoras umidificadas na regulação térmica do recém-nascido prematuro. Método: procedeu-se metodologicamente a uma revisão integrativa, nas bases de dados no período de 2005-2015, selecionando 10 artigos mediante os critérios de inclusão. Resultados: a análise dos artigos ressalta variação das práticas de regulação da umidade em incubadoras neonatais. A manutenção da temperatura corporal foi semelhante nos prematuros que permaneceram em incubadora umidificada comparados aos mantidos em incubadora convencional, porém houve redução da perda transepidérmica, da taxa de infusão de fluidos, desequilíbrios eletrolíticos e menor perda de peso e taxas de infecção não elevadas. Conclusão: evidenciou--se ausência de publicações nacionais sobre o tema e repercussões satisfatórias sobre a utilização da umidade em altas concentrações comparada à baixa umidade, contudo mais pesquisas são necessárias para definição de um padrão para a prática segura da umidificação em ambiente de incubadora.Descritores: Recém-nascido prematuro; Incubadoras para lactentes; Umidade.Objective: to analyze, in scientific literature, the repercussions of the use of humidified incubators in the thermal regulation of the preterm newborn. Method: a methodological procedure for an integrative review, in databases for the period 2005-2015, selecting 10 articles using the inclusion criteria. Results: the analysis of articles highlights the wide variation of moisture regulation practices in neonatal incubators. Maintaining body temperature was similar in preterm infants who remained in humidified incubators when compared to those in conventional incubators; however, there was a reduction of transepidermal loss, fluid infusion rate, electrolyte imbalances and lower weight loss, and no high infection rates. Conclusion: the lack of national literature on the matter was evidenced and satisfactory repercussions on the use of high concentration humidity compared to low humidity, nevertheless, more research is required to define a standard for safe practice of humidification in the environment of incubators.

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Role of effective thermoregulation in premature neonates

Cited by 21 publications

References 47 publications

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

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

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

Repercussões Do Uso De Incubadoras Umidificadas Na Regulação Térmica Do Prematuro: Uma Revisão Integrativa

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