Nahimana E, May L, Gadgil A, Rapp V, Magge H, Kubwimana M, Nshimyiryo A, Kateera F, Feldman H A, Nkikabahizi F, Sayinzoga F, Hansen A
Partners In Health, Inshuti Mu Buzima, Kigali, Rwanda.
Boston Children's Hospital, Boston, Massachusetts, USA.
Public Health Action. 2018 Dec 21;8(4):211-217. doi: 10.5588/pha.18.0031.
Rural Rwandan hospitals, where thermoregulation is critical yet a challenge for pre-term, low-birth-weight (LBW) or sick newborns. To assess the safety, effectiveness, and feasibility of an inexpensive, reusable, non-electric warmer to complement kangaroo mother care (KMC). Prospective single-arm, non-randomized intervention study. Enrolled infants were hypothermic or at risk of hypothermia due to prematurity/LBW. Infants used the warmer in conjunction with KMC or as the sole source of external heat. Temperatures of the infant, warmer and air were measured for up to 6 h. Overall, 33 patients used the warmer for 102 encounters: 43 hypothermic and 59 at risk of hypothermia. In 7/102 encounters (7%), the infant developed a temperature of >37.5°C (37.6°-38.2°C). For 43 hypothermic encounters and 59 at-risk encounters, hypothermia was corrected/prevented in respectively 41 (95%) and 59 (100%) instances. The warmer maintained goal temperature for the study duration in ⩾85% of uses. Two/12 warmers broke down after <10 uses. In no instances was the warmer used incorrectly. Our results are promising for this prototype design, and warrant testing on a wider scale.
卢旺达农村地区的医院,对于早产儿、低体重儿或患病新生儿来说,体温调节至关重要但却面临挑战。为评估一种廉价、可重复使用的非电动保暖器作为袋鼠式护理(KMC)补充措施的安全性、有效性和可行性。进行前瞻性单臂、非随机干预研究。纳入的婴儿因早产/低体重而体温过低或有体温过低风险。婴儿将保暖器与KMC联合使用或作为外部热量的唯一来源。对婴儿、保暖器和空气的温度进行长达6小时的测量。总体而言,33名患者使用保暖器进行了102次接触:43名体温过低,59名有体温过低风险。在102次接触中有7次(7%)婴儿体温超过37.5°C(37.6°-38.2°C)。对于43次体温过低接触和59次有风险接触,分别有41次(95%)和59次(100%)体温过低得到纠正/预防。在⩾85%的使用过程中,保暖器在研究期间维持了目标温度。12个保暖器中有2个在使用不到10次后出现故障。在任何情况下,保暖器都没有被错误使用。我们的结果对于这种原型设计很有前景,值得进行更广泛的测试。