Humidified and heated air during stabilization at birth improves temperature in preterm infants.
OBJECTIVE
Neonatal resuscitation guidelines recommend techniques to minimize heat loss in the delivery room. The use of humidified and heated gas is standard of care for preterm infants who need respiratory support in the NICU, but international resuscitation guidelines do not stipulate use of this therapy during stabilization at birth. We aimed to investigate the effect of humidified and heated gas on admission temperature in preterm infants who require respiratory support at birth.


METHODS
Two cohorts of very preterm infants born at < or = 32 weeks' gestational age in the Leiden University Medical Center were compared prospectively before (the "cold" cohort) and after (the "heated" cohort) introduction of the use of heated and humidified gas during respiratory support at birth (continuous positive airway pressure or intubation). The primary outcome was the infant's rectal temperature at admission in the NICU.


RESULTS
There was a difference in the mean (SD) rectal temperature between the cold and heated cohorts (35.9 [0.6] vs 36.4 [0.6], respectively; P < .0001). Normothermia (36.5 degrees C-37.5 degrees C) occurred less often in the cold cohort than in the heated cohort (12% vs 43%; P < .0001). There was no difference in occurrence of mild hypothermia (36.0 degrees C-36.4 degrees C) between groups (33% vs 35%; not significant). Moderate hypothermia (<36.0 degrees C) occurred more often in the cold cohort (53% vs 19%; P < .001).


CONCLUSIONS
The use of heated and humidified air during respiratory support in very preterm infants just after birth reduced the postnatal decrease in temperature. Heating and humidifying the gas during stabilization merits additional investigation.
te Pas
Arjan B
AB
Department of Pediatrics, Leiden University Medical Center, J6-S, PO Box 9600, 2300 RC Leiden, Netherlands. a.b.te_pas@lumc.nl
Lopriore
Enrico
E
Dito
Ingrid
I
Morley
Colin J
CJ
Walther
Frans J
FJ
D000388:Air; D001833:Body Temperature Regulation / Q000502:physiology*; D045422:Continuous Positive Airway Pressure; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D006813:Humidity; D007035:Hypothermia / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007442:Intubation, Intratracheal; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods*