Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Child Health, The University of Dundee, Dundee, United Kingdom.
Department of Newborn Research, The Royal Women's Hospital, Melbourne, Australia; The Murdoch Childrens Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
J Pediatr. 2018 Feb;193:47-53. doi: 10.1016/j.jpeds.2017.09.006. Epub 2017 Nov 6.
To determine whether the use of heated-humidified gases for respiratory support during the stabilization of infants <30 weeks of gestational age (GA) in the delivery room reduces rates of hypothermia on admission to the neonatal intensive care unit (NICU).
A multicenter, unblinded, randomized trial was conducted in Melbourne, Australia, between February 2013 and June 2015. Infants <30 weeks of GA were randomly assigned to receive either heated-humidified gases or unconditioned gases during stabilization in the delivery room and during transport to NICU. Infants born to mothers with pyrexia >38°C were excluded. Primary outcome was rate of hypothermia on NICU admission (rectal temperature <36.5°C).
A total of 273 infants were enrolled. Fewer infants in the heated-humidified group were hypothermic on admission to NICU (36/132 [27%]) compared with controls (61/141 [43%], P < .01). There was no difference in rates of hyperthermia (>37.5°C); 20% (27/132) in the heated-humidified group compared with 16% (22/141) in the controls (P = .30). There were no differences in mortality or respiratory outcomes.
The use of heated-humidified gases in the delivery room significantly reduces hypothermia on admission to NICU in preterm infants, without increased risk of hyperthermia.
Australian and New Zealand Clinical Trials Register (www.anzctr.org.au) ACTRN12613000093785.
确定在产房稳定 <30 周胎龄（GA）的婴儿期间使用加热湿化气体进行呼吸支持是否会降低新生儿重症监护病房（NICU）入院时体温过低的发生率。
2013 年 2 月至 2015 年 6 月在澳大利亚墨尔本进行了一项多中心、非盲、随机试验。<30 周 GA 的婴儿被随机分配在产房稳定期间和转运至 NICU 期间接受加热湿化气体或未调节气体。排除母亲发热 >38°C 的婴儿。主要结局是 NICU 入院时体温过低的发生率（直肠温度 <36.5°C）。
共有 273 名婴儿入组。加热湿化组中 NICU 入院时体温过低的婴儿较少（36/132 [27%]），而对照组为 61/141 [43%]，P <.01）。高热（>37.5°C）的发生率无差异；加热湿化组为 20%（27/132），对照组为 16%（22/141）（P =.30）。死亡率或呼吸结局无差异。
在产房使用加热湿化气体可显著降低早产儿 NICU 入院时体温过低的发生率，而不会增加高热的风险。
澳大利亚和新西兰临床试验注册（www.anzctr.org.au）ACTRN12613000093785。
