Bissinger Robin L, Annibale David J
College of Nursing, Medical University of South Carolina, USA.
Adv Neonatal Care. 2010 Oct;10(5):230-8. doi: 10.1097/ANC.0b013e3181f0ae63.
The survival of very low-birth-weight (VLBW) infants has been shown to be effected by alterations in thermoregulation. Morbidity and mortality in these VLBW infants has remained higher than those in any other group of infants because of their innate vulnerability and because of exposure to risk factors in the environment. This leaves the premature infant vulnerable to cold stress especially in the first hours to weeks of life. At birth, the VLBW infant emerges from a warm, fluid environment and is thrust into a cold, abrasive environment before the protective layers of the epidermis have developed. Within minutes of birth, the core temperature begins to fall, particularly in infants whose birth weights are less than 1500 g. Hypothermia is a major cause of morbidity and mortality in infants; therefore, maintaining normal body temperatures in the delivery room is crucial. We reviewed evidence related to thermoregulation at birth in VLBW infants, including transepidermal water loss and temperature control in the delivery room, during stabilization and upon admission to the neonatal intensive care unit. Delivery room management that focuses on the adaptation of the infant as well as early interventions that improve long-term outcomes may emphasize the "golden hour" of care and improve outcomes in this extremely vulnerable population.
极低出生体重（VLBW）婴儿的存活已被证明会受到体温调节变化的影响。由于这些极低出生体重婴儿先天脆弱且暴露于环境中的危险因素，他们的发病率和死亡率一直高于其他任何一组婴儿。这使得早产儿尤其在出生后的最初数小时至数周内易受冷应激影响。出生时，极低出生体重婴儿从温暖、充满液体的环境中出来，在表皮保护层发育之前就被推入寒冷、粗糙的环境中。出生后几分钟内，核心体温就开始下降，尤其是出生体重小于1500克的婴儿。体温过低是婴儿发病和死亡的主要原因；因此，在产房维持正常体温至关重要。我们回顾了与极低出生体重婴儿出生时体温调节相关的证据，包括经皮水分流失以及在产房、稳定期和进入新生儿重症监护病房时的体温控制。注重婴儿适应以及改善长期预后的早期干预措施的产房管理可能会强调“黄金一小时”护理，并改善这一极其脆弱人群的预后。
