title: Heat Loss Prevention (HeLP) in the delivery room: A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants.
abstract: OBJECTIVE
  To determine if polyethylene occlusive skin wrapping of very preterm infants prevents heat loss after delivery better than conventional drying and to evaluate if any benefit is sustained after wrap removal.
  
  
  METHODS
  This was a randomized controlled trial of infants <28 weeks' gestation. The experimental group was wrapped from the neck down. Only the head was dried. Control infants were dried completely. Rectal temperatures were compared on admission to the neonatal intensive care unit immediately after wrap removal and 1 hour later.
  
  
  RESULTS
  Of 55 infants randomly assigned (28 wrap, 27 control), 2 died in the delivery room and 53 completed the study. Wrapped infants had a higher mean rectal admission temperature, 36.5 degrees C (SD, 0.8 degrees C), compared with 35.6 degrees C (SD, 1.3 degrees C) in control infants ( P = .002). One hour later, mean rectal temperatures were similar in both groups (36.6 degrees C, SD, 0.7 degrees C vs 36.4 degrees C, SD, 0.9 degrees C, P = .4). Size at birth was an important determinant of heat loss: Mean rectal admission temperature increased by 0.21 degrees C (95% CI, 0.04 to 0.4) with each 100-g increase in birth weight.
  
  
  CONCLUSIONS
  Polyethylene occlusive skin wrapping prevents rather than delays heat loss at delivery in very preterm infants.
authors.affiliation: Department of Pediatrics, McMaster University, the Children's Hospital of Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Sunita
authors.initials: S
authors.lastname: Vohra
authors.forename: Robin S
authors.initials: RS
authors.lastname: Roberts
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Marianne
authors.initials: M
authors.lastname: Janes
authors.forename: Barbara
authors.initials: B
authors.lastname: Schmidt
mesh_terms: D001034:Apgar Score; D001831:Body Temperature; D001833:Body Temperature Regulation; D005260:Female; D005865:Gestational Age; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D009779:Occlusive Dressings; D011095:Polyethylenes
chemical_list: D011095:Polyethylenes