The National Maternity Hospital, Holles Street, Dublin, Ireland.
Pediatrics. 2013 Jul;132(1):e135-41. doi: 10.1542/peds.2013-0279. Epub 2013 Jun 17.
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.
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.
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).
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.
新生儿重症监护病房（NICU）入院时体温过低与早产儿死亡率增加有关。尽管使用了聚乙烯袋（PBs），许多新生儿在入院时仍处于体温过低状态。除了使用 PB 外，使用发热床垫（EMs）可能会降低体温过低的发生率，但会增加体温过高的发生率。我们希望确定将早产儿放在 EM 上的 PB 中，是否会导致更多的新生儿在 NICU 入院时直肠温度超出 36.5 至 37.5°C 的范围。
在出生前，将 <31 周的婴儿随机分为接受或不接受 EM 治疗的两组。所有婴儿在出生后立即被放置在 PB 中，并在辐射热下，然后在转运培养箱中被带到 NICU。随机分配到 EM 的婴儿在出生后立即放在床垫上，并在入院前一直躺在上面。随机化按胎龄分层。NICU 入院时，使用数字温度计测量直肠温度。
数据安全监测委员会在分析了计划样本的一半数据后，建议因疗效而停止研究。我们报告此时纳入的 72 名婴儿的数据。在 EM 上使用 PB 的婴儿中，体温在目标范围内的婴儿较少（15/37 [41%] 与 27/35 [77%]，P =.002），体温 >37.5°C 的婴儿较多（17/37 [46%] 与 6/35 [17%]，P =.009）。
在非常早产儿中，在 DR 中除了使用 PB 外，还使用 EMs 会导致更多的婴儿在 NICU 入院时体温不在正常范围内，且体温过高的发生率更高。
