Clinical Case Reports

Biography

Biography: Aiman Rahmani

Abstract

Objectives- To evaluate the effect of various environmental and systemic factors on the incidence of Hypothermia upon admission to NICU for infants below 35 weeks gestation and to suggest methods of improving the outcome of these infant. Method- We compared the admission temperature of a prospective cohort of preterm  35 weeks gestation managed using standard resuscitation procedure and compared theses temperature to international parameters described by the AAP and WHO standards for temperature control of preterm infants. Results- The proportion of infants who had normal temperature on arrival to NICU (defined as body temperature of 36.5-37.5o C) as 40 % compared to the international goal of 90%. There were 20 % infants who had hypothermia on arrival to NICU defined by body temperature of < 36.0 o C compared to the goal of < 20 %. There was no hyperthermia noted on admission. The room temperature met the recommendation of >25 o C in only 40 % of cases where preterm delivery occurred. All preterm were resuscitated under pre-warmed radiant warmer, although only 30% on neonates were cared for using servo-control mode during resuscitation. In addition there was no one assigned to temperature control. During transfer to NCIU all infants were placed in warmed incubator, all newborns under 28 weeks gestation were placed in polyethylene bag and fitted with plastic hats, although chemical warming mattress was not used for any of these infants during resuscitation. Conclusion- Hypothermia in preterm infants remains a frequent problem that leads to increased morbidity. In order to improve thermal regulation of these infants the following steps are necessary: Temperature control in the delivery room need to be adjusted to achieve at least 25°C to be in accordance with WHO and NRP guidelines: 1- A Pre-warm the Resuscitator should be in use for resuscitating preterm infants. 2- One person should be assigned to the additional task of temperature control. 3- Servo-control mode should be used to support temperature regulation for all preterm babies. 4- A chemical mattresses until the infant should be placed in a pre-warmed bed or incubator in the NICU. 5- Transport of preterm infant should be done by using pre-warmed transport incubator 6- Polyethylene bag and cap should be used for all babies <29week gestation. 7- Staff education regarding the importance of all the measures and side effects of hypothermia in the preterm babies is the key for proper thermal control