Study by Direct Calorimetry of Thermal Balance on the First Day of Life

Ryser, G.; Jéquier, E

doi:10.1111/j.1365-2362.1972.tb00587.x

Cited by 42 publications

(20 citation statements)

References 33 publications

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“…The fetus is a metabolically active organism whose temperature closely follows maternal temperature, forming a heat clamp, and remains 0.5 1C higher. [27][28][29] This heat clamp creates a steady state and provides the fetus with a thermostable environment. 30 Although the fetus develops in a warm and thermostable environment, its basal heat production (kcal kg À1 ) is about twice that of adult levels.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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“…Sweating has been reported to occur in newborn babies with a core temperature of 37.3˚C or more in combination with a temperature difference between core and mean skin temperature of less than 1˚C. 4 …”

Section: Heat Lossesmentioning

confidence: 99%

“…[2][3][4][5] This study is descriptive, aiming to define temperature variations of the neonate during normal care in the first two days of life in a maternity ward of a western European country. The following were recorded.…”

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confidence: 99%

Temperature variation in newborn babies: importance of physical contact with the mother

Fransson

2005

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Background: Hypothermia is a major cause of deterioration and death in the neonatal period. Temperature deviations are key signs of illness. Objective: To determine normal patterns of temperature variation in newborn babies and the influence of external factors. Methods: Abdominal and foot skin temperature were continuously recorded in 27 healthy full term babies during the first two days of life and related to the care situation-that is, whether the baby was with the mother or in its cot. The recordings were made using no wires to avoid interference with the care of the neonate. Ambient temperature was close to 23˚C during the study period. Results: Mean rectal and abdominal and foot skin temperature were lower on day 1 than day 2. The foot skin temperature was directly related to the care situation, being significantly higher when the baby was with the mother. The abdominal skin temperature was much less influenced by external factors. When the neonates were with their mothers, the mean difference between rectal temperature and abdominal skin temperature was 0.2˚C compared with a mean difference between rectal temperature and foot skin temperature of 1.5˚C, indicating a positive heat balance. In the cot the corresponding temperature differences were 0.7˚C and 7.5˚C. A temperature difference between rectal and foot skin temperature of 7-8˚C indicates a heat loss close to the maximum for which a neonate can compensate (about 70 W/m 2 ). Conclusion: This study emphasises the importance of close physical contact with the mothers for temperature regulation during the first few postnatal days.

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“…Furthermore, Ryser and J^quier [30] found that the metabolic rate continuously diminished as the environment became by 2° or 4° warmer than the neutral temperature.…”

Section: Metabolic Ratementioning

confidence: 99%

Thermal Balance of the Newborn Infant in a Heat-gaining Environment

1973

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ExtractThe thermal balance of 22 full term, 9 small for date, and 8 large premature infants was studied by gradient layer direct calorimetry on the 1st day of life. In addition, the influence of muscular activity on the ability to sweat of 8 full term infants was investigated. The same measurements were repeated in 20 infants on the 3rd day of life.All i nfants were subjected to the same experimental conditions: ambient temperature 37°, restive humidity 50%, and air flow 30 liters/min.It was demonstrated that the evaporation of water was the primary way to dissipate heat in a heat-gaining environment. Active thermoregulatory sweating was elicited at deep body temperatures of 37.45°, 37.8°, and 37.76° in the full term, small for date, and premature infants, respectively.The set-point temperature of sweating tended to be lower with increasing gestational and postnatal age, and with vigorous muscular activity. The physiologic weight loss of about 3%, and the intrauterine growth retardation resulted in significant increase in this threshold temperature.The maximal sweat rate of the premature infants (1.43 W/kg) was significantly lower than that of the full term (1.81 W/kg) and small for date infants (2.32 W/kg): P < 0.05 and 0.01, respectively.Heat loss by radiation and convection was directly related to the mean skin temperature; it was only when the latter reached the value of 37° that radiative plus convective heat loss became positive.There was a close inverse relation between the total heat loss and heat storage. After the beginning of sweating, the heat storage of full term and small for date infants sharply decreased and stabilized around 0, which showed that a new thermal steady state was reached. The premature infant was not able to reach this new equilibrium and the heat storage remained positive.The full term and small for date infants could keep the body temperature at a steady level of 37.66° and 37.98°, respectively, whereas the esophageal temperature of the premature infants kept on increasing.The cutaneous thermal conductance, an indicator of the heat-transferring blood flow, was at first negative, which showed that heat was transferred from the surface to the core. Later, before the evaporative heat loss, it increased and reached the maximal value at a body temperature of 37.6° in the normal, and of 37.9° in both the small for date and premature groups.The metabolic rate for the small for date and premature infants was significantly higher than that for the full term infants, and it directly related to the deep body temperature in each group. Neonatal thermal balance 889In the new thermal equilibrium, the metabolic rate of the full term infants was about 20% lower than that measured under neutral ambient conditions. We suggest that the term "neutral thermal environment" must be reconsidered. SpeculationA new method, gradient layer direct calorimetry, gave us the opportunity to measure directly the different heat losses of the neonate under well controlled experimental conditions, and to compare thes...

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Study by Direct Calorimetry of Thermal Balance on the First Day of Life

Cited by 42 publications

References 33 publications

Neonatal hypothermia in low resource settings: a review

Neonatal hypothermia in low resource settings: a review

Temperature variation in newborn babies: importance of physical contact with the mother

Thermal Balance of the Newborn Infant in a Heat-gaining Environment

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