Improved outcome of hypothermic infants.

Fifty-six hypothermic infants (23 to 34 degrees C), aged four to 113 days, admitted during the winter months over a three-year period are reported. Low weight and malnutrition were frequent findings on admission. One or more severe associated disturbances, including metabolic abnormalities, bleeding tendency, infection, and respiratory failure were observed in most cases. All 56 patients were closely monitored for vital signs and metabolic status. Thirty-eight received conventional slow warming, but 18 of the worst cases received rapid warming. These 18 were among the 24 cases treated in a pediatric intensive care unit. Fourteen of the 56 infants required assisted mechanical ventilation. Fifty-three of 56 infants survived. Of the three who died, none was rapidly warmed, and two of them had severe underlying central nervous system infection. Hypothermia of infancy and the associated disturbances are treatable today, on condition that modern medical facilities are available. It appears that the warming method has been overly stressed.