Use of self-heating gel mattresses eliminates admission hypothermia in infants born below 28 weeks gestation

Ibrahim, C P H; Yoxall, C W

doi:10.1007/s00431-009-1113-y

Cited by 42 publications

(20 citation statements)

References 16 publications

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“…10 In practice the activated EM acts as an external heat source so that when infants are placed on a warm EM, they absorb heat by conduction through the surface of their skin in contact with the EM. In 2 retrospective studies, less hypothermia was observed when infants in PBs were placed on EMs in the DR compared with previous cohorts when EMs were not used (23% vs 3% 11 and 69% vs 26% 12 ). In both studies, the rate of hyperthermia increased with the addition of the EM (50% 11 and 28% 12 ).…”

Section: Discussionmentioning

confidence: 91%

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

et al. 2013

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BACKGROUND AND OBJECTIVE: Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission. METHODS: Infants <31 weeks were randomly assigned before birth to treatment with or without an EM. All infants were placed in a PB and under radiant heat immediately after birth and brought to NICU in a transport incubator. Infants randomly assigned to EM were placed on a mattress immediately after delivery and remained on it until admission. Randomization was stratified by gestational age. Rectal temperature was measured with a digital thermometer on NICU admission. RESULTS: The data safety monitoring committee recommended stopping for efficacy after analyzing data from half the planned sample. We report data for 72 infants enrolled at this time. Fewer infants in PBs on EMs had temperatures within the target range (15/37 [41%] vs 27/35 [77%], P = .002) and more had temperatures >37.5°C (17/37 [46%] vs 6/35 [17%], P = .009). CONCLUSIONS: In very preterm newborns, using EMs in addition to PBs in the DR resulted in more infants with temperatures outside the normal range and more hyperthermia on NICU admission.

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Section: Discussionmentioning

confidence: 91%

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

et al. 2013

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“…18,25,29 Furthermore, the large sample size and our consistent rates of normothermia indicate that these results did not occur by chance. From a safety perspective, our ability to prevent hypothermia without incurring hyperthermia or other obvious complications of resuscitation is important, because this has been a concern in some previous studies, 20,25,26,30 and it may also contribute to morbidity. 31 Qualitative, unplanned observations of staff dynamics raised the possibility that standardizing temperature measurements, which was aimed at maximizing accuracy and avoiding biases, serendipitously became an intangible intervention.…”

Section: Discussionmentioning

confidence: 99%

Decreasing Hypothermia During Delivery Room Stabilization of Preterm Neonates

Pinheiro¹,

Furdon²,

Boynton³

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Hypothermia during delivery room stabilization of very low birth weight (VLBW) newborns is independently associated with mortality, yet it occurred frequently both in collaborative networks and at our institution. We aimed to attain admission temperatures in the target range of 36°C to 38°C in $90% of inborn VLBW neonates through implementation of a thermoregulation bundle.METHODS: This quality improvement project extended over 60 consecutive months, using sequential plan-do-check-act cycles. During the 14 baseline months, we standardized temperature measurements and developed the Operation Toasty Tot thermoregulation bundle (including consistent head and torso wrapping with plastic, warmed blankets, and a closed stabilization room). We introduced this bundle in month 15 and added servo-controlled, battery-powered radiant warmers for stabilization and transfer in month 21. We provided results and feedback to staff throughout, using simple graphics and control charts.RESULTS: There were 164 inborn VLBW babies before and 477 after bundle implementation. Introduction and optimization of the bundle decreased the incidence of hypothermia, with rates remaining in the target range for the last 13 study months. The incidence of temperatures .38°C was ∼2% both before and after bundle implementation.CONCLUSIONS: This thermoregulation bundle resulted in sustained improvement in normothermia rates during delivery room stabilization of VLBW newborns. Our benchmark goal of $90% admission temperatures above 36°C was met without increasing hyperthermia rates. Because these results compare favorably with those of recently published research or improvement collaboratives, we aim to maintain our performance through routine surveillance of admission temperatures. Pediatrics 2014;133:e218-e226 Dr Pinheiro contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim and final data analyses and interpretation, and drafted the initial manuscript; Ms Furdon contributed to the initial design and implementation of the project, collaborated in data acquisition, performed interim data analyses and interpretation, and collaborated in the initial draft and revisions of the manuscript; Ms Boynton, Ms Dugan, and Ms Reu-Donlon contributed to the initial design and implementation of the project, collaborated in data acquisition, and reviewed and revised the manuscript; Ms Jensen contributed to the initial design and implementation of the project, performed data analyses and interpretation in the early phases of the project, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…Various combinations of these strategies may be reasonable to prevent hypothermia in infants born at less than 32 weeks of gestation (Class IIb, LOE B-R, B-NR, C-LD). Compared with plastic wrap and radiant warmer, the addition of a thermal mattress, [66][67][68][69][70] warmed humidified gases, 71,72 and increased room temperature plus cap plus thermal mattress 55,57,59,73 were all effective in reducing hypothermia. For all the studies, hyperthermia was a concern, but harm was not shown.…”

Section: Nrp 599mentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Circulation

609

344

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Use of self-heating gel mattresses eliminates admission hypothermia in infants born below 28 weeks gestation

Abstract: Self-heating acetate gel mattresses are highly effective in reducing admission hypothermia in infants born at or below 28 weeks gestation. The use of these mattresses is associated with a significant increase in hyperthermia.

Cited by 42 publications

References 16 publications

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

A Randomized Trial of Exothermic Mattresses for Preterm Newborns in Polyethylene Bags

Decreasing Hypothermia During Delivery Room Stabilization of Preterm Neonates

Part 13: Neonatal Resuscitation

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