Knobel-Dail Robin B, Sloane Richard, Holditch-Davis Diane, Tanaka David T
Robin B. Knobel-Dail, PhD, RN, FAAN, is Professor and Associate Dean for Faculty Affairs, College of Nursing, University of South Carolina, Columbia. At the time this research was completed, she was Associate Professor, Duke University School of Nursing and Duke University School of Medicine, Durham, North Carolina. Richard Sloane, MPH, is Biostatistician and Senior Staff, Duke University Center for the Study of Aging and Human Development, Durham, North Carolina. Diane Holditch-Davis, PhD, RN, FAAN, is Professor Emeritus, Duke University School of Nursing, Durham, North Carolina. David T. Tanaka, MD, is Professor, Department of Pediatrics and Neonatology, Duke University School of Medicine, Durham, North Carolina.
Nurs Res. 2017 Nov/Dec;66(6):442-453. doi: 10.1097/NNR.0000000000000250.
Hypothermia is related to increased morbidity and mortality in very preterm infants; continuous temperature monitoring is necessary. Thermoregulation is limited in preterm infants.
The purpose of the research was to assess and describe negative temperature differential (NTD) and assess the associations of NTD with infant demographic characteristics, medical history, and clinical events.
An exploratory, case study design was used. Abdominal and foot temperature was measured every minute over the first 2 weeks of life in 22 preterm infants at less than 29 weeks gestational age.
All infants experienced NTD. Daily NTD in all infants across all study days ranged from 0 to 70.7%; 2-week mean NTD over all infants ranged from 7.3% to 38.5%. Four infants treated for late onset of infection had a higher NTD than 18 infants without infection (M = 27.8%, SD = 9.52 vs. M = 16.4%, SD = 5.34, p < .05). Although not statistically significant, higher mean percentage of NTD was noted in infants having early onset infection (24.1% vs. 16.4%), African American race (20.0% vs. 15.3%), and/or being born to a mother who smoked during pregnancy (26.6% vs. 16.7%).
A larger study is needed to examine associations between NTD and race, maternal smoking history, and infection. NTD might be used as a biomarker to guide acute clinical care and identify infants at risk for acute and chronic morbidity.
体温过低与极早产儿发病率和死亡率的增加有关；持续体温监测很有必要。早产儿的体温调节能力有限。
本研究的目的是评估和描述负温差（NTD），并评估NTD与婴儿人口统计学特征、病史和临床事件之间的关联。
采用探索性病例研究设计。对22名胎龄小于29周的早产儿在出生后前2周内每分钟测量一次腹部和足部温度。
所有婴儿均经历了负温差。在所有研究日中，所有婴儿的每日负温差范围为0至70.7%；所有婴儿的2周平均负温差范围为7.3%至38.5%。4名因晚发性感染接受治疗的婴儿的负温差高于18名未感染的婴儿（M = 27.8%，SD = 9.52 vs. M = 16.4%，SD = 5.34，p <.05）。虽然无统计学意义，但在患有早发性感染（24.1% vs. 16.4%）、非裔美国人种族（20.0% vs. 15.3%）和/或母亲在孕期吸烟的婴儿中，负温差的平均百分比更高（26.6% vs. 16.7%）。
需要进行更大规模的研究来检验负温差与种族、母亲吸烟史和感染之间的关联。负温差可作为一种生物标志物，用于指导急性临床护理并识别有急性和慢性发病风险的婴儿。
