Reducinǵ hypothermia in preterm infants followinǵ delivery

Anne Russo, Mary McCready, Lisandra Torres, Claudette Theuriere, Susan Venturini, Morǵan Spaiǵht, Rae Jean Hemway, Suzanne Handrinos, Deborah Perlmutter, Tranǵ Huynh, Amos Grunebaum, Jeffrey Perlman

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

BACKGROUND: Moderate hypothermia (temperature <36°C) at birth is common in premature infants and is associated with increased mortality and morbidity. METHODS: A multidisciplinary practice plan was implemented to determine in premature infants <35 weeks old whether a multifaceted approach would reduce the number of inborn infants with an admittinǵ axillary temperature <36°C by 20% without increasing exposure to a temperature >37.5°C. The plan included use of occlusive wrap a transwarmer mattress and cap for all infants and maintaininǵ an operatinǵ room temperature between 21°C and 23°C. Data were obtained at baseline (n = 66), during phasing in (n = 102), and at full implementation (n = 193). RESULTS: Infant axillary temperature in the delivery room (DR) increased from 36.1°C ± 0.6°C to 36.2°C ± 0.6°C to 36.6°C ± 0.6°C (P > .001), and admitting temperature increased from 36.0°C ± 0.8°C to 36.3°C ± 0.6°C to 36.7°C ± 0.5°C at baseline, phasing in, and full implementation, respectively (P < .001). The number of infants with temperature <36°C decreased from 55% to 6.2% at baseline versus full implementation (P < .001), and intubation at 24 hours decreased from 39% to 17.6% (P = .005). There was no increase in the number of infants with a temperature >37.5°C over time. The use of occlusive wrap, mattress, and cap increased from 33% to 88% at baseline versus full implementation. Control charts showed significant improvement in DR ambient temperature at baseline versus full implementation. CONCLUSIONS: The practice plan was associated with a significant increase in DR and admitting axillary infant temperatures and a corresponding decrease in the number of infants with moderate hypothermia. There was an associated reduction in intubation at 24 hours. These positive findings reflect increased compliance with the practice plan.

Original languageEnglish (US)
Pages (from-to)e1055-e1062
JournalPediatrics
Volume133
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Hypothermia
  • Newborn
  • Quality improvement
  • Temperature

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Russo, A., McCready, M., Torres, L., Theuriere, C., Venturini, S., Spaiǵht, M., Hemway, R. J., Handrinos, S., Perlmutter, D., Huynh, T., Grunebaum, A., & Perlman, J. (2014). Reducinǵ hypothermia in preterm infants followinǵ delivery. Pediatrics, 133(4), e1055-e1062. https://doi.org/10.1542/peds.2013-2544