Rohana Jaafar, Khairina Wan, Boo Nem Yun, Shareena Ishak
Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Pediatr Int. 2011 Aug;53(4):468-74. doi: 10.1111/j.1442-200X.2010.03295.x.
Occlusive plastic applied immediately after birth to reduce evaporative heat loss has been proven effective in preterm infants <28 weeks' gestation. However its effectiveness on preterm infants >28 weeks' gestation has not been shown. This study aimed to determine the effect of occlusive wrap at birth on the temperature at neonatal intensive care unit (NICU) admission among infants of greater than or equal to 24 weeks' and less than 34 weeks' gestation.
Study infants were randomly assigned to "wrap" or "control" groups. Newborns in the wrap group were wrapped with polyethylene plastic sheets within the first min after birth. Infants randomized to the control group were dried immediately after birth with warmed towels under a warmer, according to the guidelines of Neonatal Resuscitation. Infants' axillary temperatures were measured on admission to the NICU, and after having been stabilized in incubators in the NICU.
A total of 110 infants were recruited into the study. The mean admission temperature was significantly higher in the wrap group (35.8 vs 34.8°C, P < 0.01). Admission hypothermia (axillary temperature <36.5°C) was present in 38 (78%) and 58 (98%) infants in the wrap and control groups, respectively. Among infants of <28 weeks' gestation, the post-stabilization temperature was significantly higher in the wrap group.
Wrapping premature infants with gestational age <34 weeks in polyethylene plastics immediately after birth is associated with lower incidence of hypothermia.
出生后立即应用封闭性塑料薄膜以减少蒸发散热,已被证明对孕周小于28周的早产儿有效。然而,其对孕周大于28周的早产儿的有效性尚未得到证实。本研究旨在确定出生时使用封闭性包裹对孕周大于或等于24周且小于34周的婴儿入住新生儿重症监护病房(NICU)时体温的影响。
将研究婴儿随机分为“包裹”组或“对照组”。包裹组的新生儿在出生后第一分钟内用聚乙烯塑料薄膜包裹。根据新生儿复苏指南,随机分配到对照组的婴儿在出生后立即用温暖的毛巾在暖箱下擦干。在婴儿入住NICU时以及在NICU暖箱中稳定后测量其腋温。
共有110名婴儿被纳入研究。包裹组的平均入院体温显著更高(35.8对34.8°C,P<0.01)。包裹组和对照组分别有38名(78%)和58名(98%)婴儿存在入院时体温过低(腋温<36.5°C)。在孕周小于28周的婴儿中,包裹组稳定后的体温显著更高。
出生后立即用聚乙烯塑料包裹孕周小于34周的早产儿,可降低体温过低的发生率。