Tourneux Pierre, Thiriez Gérard, Renesme Laurent, Zores Claire, Sizun Jacques, Kuhn Pierre
Neonatal Intensive Care Unit, Amiens University Hospital, Amiens, France.
PériTox Laboratory UMR_I 01, UFR de Médecine, University of Picardie Jules Verne, Amiens, France.
Acta Paediatr. 2022 Aug;111(8):1490-1499. doi: 10.1111/apa.16407. Epub 2022 May 30.
Thermal instability is harmful on the newborn infant. We sought to draw up practical guidelines on maintaining homeothermy alongside skin-to-skin contact.
A systematic analysis of the literature identified relevant studies between 2000 and 2021 in the PubMed database. Selected publications were evaluated, and their level of evidence was graded, in order to underpin the development of clinical guidelines.
We identified 7 meta-analyses and 64 clinical studies with a focus on newborn infants homeothermy. Skin-to-skin contact is the easiest and most rapidly implementable method to prevent body heat loss. Alongside skin-to-skin contact, monitoring the newborn infant's body temperature with a target of 37.0°C is essential. For newborn infants <32 weeks of gestation, a skullcap and a polyethylene bag should be used in the delivery room or during transport. To limit water loss, inhaled gases humidification and warming is recommended, and preterm infants weighing less than 1600 g should be nursed in a closed, convective incubator. With regard to incubators, there are no clear benefits for single- versus double-wall incubators as well as for air versus skin servo control.
Alongside skin-to-skin contact, a bundle of practical guidelines could improve the maintenance of homeothermy in the newborn infant.
体温不稳定对新生儿有害。我们试图制定关于在母婴皮肤接触期间维持体温恒定的实用指南。
对文献进行系统分析，确定了2000年至2021年期间PubMed数据库中的相关研究。对所选出版物进行评估，并对其证据水平进行分级，以支持临床指南的制定。
我们确定了7项荟萃分析和64项关注新生儿体温恒定的临床研究。母婴皮肤接触是预防体温散失最简单、最易实施的方法。除母婴皮肤接触外，以37.0°C为目标监测新生儿体温至关重要。对于孕周<32周的新生儿，应在产房或转运期间使用帽式保暖器和聚乙烯袋。为限制水分流失，建议对吸入气体进行加湿和加温，体重小于1600 g的早产儿应在密闭对流式暖箱中护理。关于暖箱，单壁与双壁暖箱以及空气与皮肤伺服控制相比，没有明显优势。
除母婴皮肤接触外，一系列实用指南可改善新生儿体温恒定的维持。
