The Influence of the Thermal Environment Upon the Survival of Newly Born Premature Infants

Silverman, William A.; Fertig, John W.; Berger, Agnes

doi:10.1542/peds.22.5.876

Cited by 454 publications

(23 citation statements)

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“…PITHI CHANVORACHOTE 1,2 , KATESAKORN JIRACHOTDECHO 3 and NITHIPUN SUKSUMEK 3 (13). Although portable incubator keeps infant temperature stable, this way of transport is considerably expensive; thereby, limited in many hospitals.…”

Section: A Randomized Controlled Trial Of Evaluating the Efficacy Of ...mentioning

confidence: 99%

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A Randomized Controlled Trial of Evaluating the Efficacy of Alternative Swaddles for Body Temperature Control of Newborns

Chanvorachote

Jirachotdecho

Suksumek

2022

In Vivo

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Background/Aim: The critical drop of body temperature in neonatal termed "hypothermia" increases risk of morbidity and mortality. In order to minimize hypothermia during delivery room to nursery transportation, we trialed for appropriate alternative means of aluminum coated fabric (ACF), cotton swaddle, and their combination. The aim of the present study was to compare the efficacy of aluminum coated fabric, cotton swaddle, and combined method to prevent neonatal hypothermia. Patients and Methods: One hundred and seventy-four of eligible infants (birth weight more than 2,500 g) were randomized into three groups (55 infants in aluminum coated fabric, 60 in combined aluminum coated fabric with cotton swaddle, and 59 in cotton swaddle as a control). Rectal temperature was determined before swaddling and arriving at nursery. Results: There was no significant difference in antenatal and perinatal factors. Normothermia was detected in 50, 52, and 55 infants and decrease body temperature from its baseline were evidenced in 25, 24, and 14 infants swaddling with aluminum coated fabric, combined aluminum coated fabric with cotton swaddle and cotton swaddle, respectively (p=0.425 and p=0.210). Interestingly, results indicated that the use of cotton swaddle, ACF, and their combination could reduce the number of hypothermic infants from 4, 3, and 6 to 0, 5, and 1, respectively, pointing that the use of cotton swaddle exhibited the maximum hypothermia recovery potential. Conclusion: The cotton swaddle showed the dominant hypothermal control over ACF and combination of cotton swaddle and ACF. These findings may benefit the development of new strategies for hypothermia prevention in newborns.

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Section: A Randomized Controlled Trial Of Evaluating the Efficacy Of ...mentioning

confidence: 99%

“…Previous well-established studies have reported that effective thermoregulation during transfer of newborns from delivery room to the nursery can increase infant survival rates (1)(2)(3)(4). The homeothermic mechanisms of newborn have limited capacity; hence, the core body temperature is frequently fluctuated as a result of altered environment temperature.…”

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confidence: 99%

A Randomized Controlled Trial of Evaluating the Efficacy of Alternative Swaddles for Body Temperature Control of Newborns

Chanvorachote

Jirachotdecho

Suksumek

2022

In Vivo

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“…Neonatal body temperature is known to have a significant effect on prognosis [ 1 – 5 ], and body temperature is inversely correlated with mortality in infants [ 1 , 2 , 4 ]. As temperature management is clinically important in neonatal care, a number of organizations, including the World Health Organization (WHO), have proposed guidelines for neonatal temperature management [ 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

A method for improving semantic segmentation using thermographic images in infants

et al. 2022

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Background Regulation of temperature is clinically important in the care of neonates because it has a significant impact on prognosis. Although probes that make contact with the skin are widely used to monitor temperature and provide spot central and peripheral temperature information, they do not provide details of the temperature distribution around the body. Although it is possible to obtain detailed temperature distributions using multiple probes, this is not clinically practical. Thermographic techniques have been reported for measurement of temperature distribution in infants. However, as these methods require manual selection of the regions of interest (ROIs), they are not suitable for introduction into clinical settings in hospitals. Here, we describe a method for segmentation of thermal images that enables continuous quantitative contactless monitoring of the temperature distribution over the whole body of neonates. Methods The semantic segmentation method, U-Net, was applied to thermal images of infants. The optimal combination of Weight Normalization, Group Normalization, and Flexible Rectified Linear Unit (FReLU) was evaluated. U-Net Generative Adversarial Network (U-Net GAN) was applied to thermal images, and a Self-Attention (SA) module was finally applied to U-Net GAN (U-Net GAN + SA) to improve precision. The semantic segmentation performance of these methods was evaluated. Results The optimal semantic segmentation performance was obtained with application of FReLU and Group Normalization to U-Net, showing accuracy of 92.9% and Mean Intersection over Union (mIoU) of 64.5%. U-Net GAN improved the performance, yielding accuracy of 93.3% and mIoU of 66.9%, and U-Net GAN + SA showed further improvement with accuracy of 93.5% and mIoU of 70.4%. Conclusions FReLU and Group Normalization are appropriate semantic segmentation methods for application to neonatal thermal images. U-Net GAN and U-Net GAN + SA significantly improved the mIoU of segmentation.

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“…Already in the early 1900s, it was recognised that small neonates could not maintain their body temperature in the absence of an appropriate thermal environment (6). In the mid-1900s, Silverman, Fertig and Berger (24) and Day et al (25) demonstrated improved survival with use of warming devices to provide adequate, stable thermal care. Much later in 1993, WHO published 'Thermal Protection of the Newborn: a practical guide' to enable healthcare personnel at all levels to be adequately informed about neonatal thermal care (6).…”

Section: Introductionmentioning

confidence: 99%

Gaps in neonatal thermal care in low-resource settings: A web-based survey of healthcare workers.

Kyokan

Jirapaet

Rosa-Mangeret

et al. 2022

Preprint

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Background: Hypothermia has been widely regarded as a major contributory factor to neonatal mortality and morbidity in low-resource settings. Despite the recognition of the importance of thermal care for neonates a century ago and the established WHO guidelines, a high prevalence of neonatal hypothermia is still regularly reported. Hypothermia is avoidable in the majority of neonates because it is not a complication of prematurity but more the result of inadequate thermal care. The objective of this study was to explore the current gaps in knowledge and practice in neonatal thermal care among healthcare workers in low-resource settings.Methods: We conducted a 2-round, web-based survey of a purposive and snowball sample of healthcare workers in neonatal care in low-resource settings. The questionnaire was developed using themes of neonatal thermal care extracted from existing neonatal care guidelines, including WHO’s. The survey asked multiple-choice questions, supplemented by open-ended questions to capture first hand insights and information on neonatal thermal care. Results of the survey were analysed using Microsoft Excel. Data was collated and summarized using descriptive measures. Results: Almost all participants acknowledged the importance of all the WHO warm chain elements, however, fewer participants responded positively regarding the practice of this warm chain. Only 56% of the participants acknowledged the usefulness of checking the hand or foot temperature by hand-touch. The usefulness of the axillary or rectal temperature was valued higher than that of the hand or foot temperature as an indicator of cold stress. Opinions diverged regarding the hand or foot temperature, including apparent inaccuracy compared to axillary or rectal temperature. Preferences on rewarming strategies widely differed among participants and so did the availability of warming equipment in their institutions. Conclusions: We identified the general acknowledgment of the importance of the WHO warm chain but also its limited practice. We also identified that an inadequate understanding of cold stress underestimates the potential benefits of the hand or foot temperature and leads to missed opportunities for timely prevention of hypothermia. Furthermore, lack of consistent guidance on equipment for rewarming hypothermic neonates hampers recovery.

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The Influence of the Thermal Environment Upon the Survival of Newly Born Premature Infants

Cited by 454 publications

References 0 publications

A Randomized Controlled Trial of Evaluating the Efficacy of Alternative Swaddles for Body Temperature Control of Newborns

A Randomized Controlled Trial of Evaluating the Efficacy of Alternative Swaddles for Body Temperature Control of Newborns

A method for improving semantic segmentation using thermographic images in infants

Gaps in neonatal thermal care in low-resource settings: A web-based survey of healthcare workers.

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