Improved care and growth outcomes by using hybrid humidified incubators in very preterm infants.
OBJECTIVE
To identify changes in temperature, fluid and electrolyte management, growth, and short-term outcome in extremely low birth weight (ELBW) infants nursed in humidified hybrid incubators (HI group) compared with a cohort of patients cared for in nonhumidified conventional incubators (CI group).


METHODS
Body temperature (BT), fluid and electrolyte balance, and growth velocity (GV) were collected retrospectively on 182 ELBW infants. The CI group included ELBW infants cared for with radiant warmers followed by an incubator without humidity. The HI group included ELBW infants cared for in the radiant warmer mode in a Giraffe OmniBed, followed by the incubator mode using high humidity.


RESULTS
The CI group included more multiple births (50.6%) than the HI group (35.8%; P < .05), but there was no difference in demographic characteristics. BT was similar during the first week. The HI group had less fluid intake, urine output, and insensible water loss, less maximum weight loss, and a lower incidence of hypernatremia during the first week than did the CI group (P < .05). The HI group also had a lower frequency of electrolyte sampling and packed red cell transfusion (P < .05), a higher incidence of hyponatremia on postnatal day 1 than the CI group (P < .05), and a higher GV than the CI group (15.2 +/- 5.0 vs 13.5 +/- 4.8 g/kg per day), especially among those with a birth weight of <or=749 g (P < .01). There was no difference in sepsis, necrotizing enterocolitis, intraventricular hemorrhage, and all bronchopulmonary dysplasia (BPD), but there was a decreased incidence of severe BPD (5.1% [HI] vs 16.4% [CI]; P < .05) and duration of assisted ventilation in the HI group compared with the CI group (15.5 +/- 2.1 vs 19.6 +/- 2.4 days, respectively; P = .068).


CONCLUSIONS
Use of a humidified hybrid incubator improved care for ELBW infants by making it possible to decrease fluid intake, improve electrolyte balance, and enhance GV without a disturbance of BT compared with conventional care. By adjusting fluid intake when using these devices, benefits may be enhanced and the risk of BPD and severe BPD may be reduced.
Kim
Sung Mi
SM
Division of Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Lee
Edward Y
EY
Chen
Jie
J
Ringer
Steven Alan
SA
D001831:Body Temperature / Q000502:physiology*; D001835:Body Weight; D002657:Child Development / Q000502:physiology; D015331:Cohort Studies; D003257:Consumer Product Safety; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006813:Humidity; D007186:Incubators, Infant; D007224:Infant Care / Q000379:methods*; D007226:Infant Mortality / Q000639:trends*; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D016012:Poisson Distribution; D011247:Pregnancy; D011336:Probability; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000502:physiology