Thermal defense of extremely low gestational age newborns during resuscitation: exothermic mattresses vs polyethylene wrap.
OBJECTIVE
The purpose of this study was to assess the effectiveness of thermal warming mattresses compared with wrapping in a polyethylene sheet during resuscitation in extremely low gestational age newborns (ELGANs) in preventing admission hypothermia in the neonatal intensive care unit.


METHODS
Patients delivered between 24 and 28 weeks gestation and ≤1250 g were eligible for this prospective, randomized study. In the delivery room, the resuscitation team opened a sealed opaque envelope for treatment group assignment to either the wrap or the sodium acetate mattress group. Resuscitation followed protocols recommended by the Neonatal Resuscitation Program. The primary outcome for this study was comparison of axillary temperatures recorded at the time of neonatal intensive care unit admission between the two groups.


RESULTS
Thirty-nine patients were enrolled in the study. The mattress group's mean admission temperature was 36.5±0.67, whereas the plastic wrap group's was 36.1±0.66 (P=0.0445).


CONCLUSIONS
Thermal mattresses improved admission temperature for ELGANs over plastic wrap. Although both plastic wrap and thermal mattresses improve the thermal status of ELGANs, all current interventions fall short of truly protecting all these vulnerable patients from thermal stress.
Simon
P
P
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. Parker-Simon@ouhsc.edu
Dannaway
D
D
Bright
B
B
Krous
L
L
Wlodaver
A
A
Burks
B
B
Thi
C
C
Milam
J
J
Escobedo
M
M
D001513:Beds; D001831:Body Temperature; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D010343:Patient Admission; D020959:Polyethylene; D011446:Prospective Studies; D012151:Resuscitation; D013315:Stress, Psychological / Q000517:prevention & control*; D016896:Treatment Outcome
D020959:Polyethylene