Comparison of Polythene Occlusive Skin Wrapping With Routine Cloth Wrapping in Reducing Heat Loss During Transportation in Preterm Neonates (<34 Weeks) After Delivery: Randomized Control Trial
BACKGROUND AND OBJECTIVE:
Preterm neonates are most vulnerable to hypothermia, especially in the first hour after birth, during which they are transported to the NICU. Transport incubators are not available in resource-poor settings, and temperature management remains a challenge. The goal of this study was to determine the efficiency of polyethylene occlusive skin wrapping versus routine cloth wrapping during intrahospital transportation after birth on the incidence of hypothermia in preterm neonates (<34 weeks) within 24 hours of life.
Preterm neonates (<34 weeks) were randomized into groups receiving either polyethylene occlusive skin wrapping (plastic group) or routine cloth wrapping (control group). Axillary temperature was recorded by using a digital thermometer in degrees centigrade at baseline (just after resuscitation), every 5 minutes in the first hour, and at 2, 3, 4, 5, 6, 12, and 24 hours of life. Interim analysis is presented.
There were 50 neonates in the plastic group and 35 in the control group. A total of 54 (63.5%) were admitted to the NICU, 10 (11.8%) received intermediate care, and 21 (24.7%) received routine care. The mean ± SD birth weight of the study population was 1663.76 ± 393.49 g (minimum: 840 g; maximum: 2300 g). Forty-five (52.9%) infants required ventilator support. Mean temperature was significantly higher in the plastic group for most time intervals. The average temperature in the plastic group increased by 0.2 degree, and it decreased by 0.06 degree in the control group during intrahospital transfer. Good thermal control was achieved and maintained in ∼10 to 15 minutes for the plastic group versus 35 to 40 minutes for the control group. The incidence of mild hypothermia (29 [82.9%] vs 29 [58.0%]; P = .015), as well as moderate hypothermia (27 [77.1%] vs 18 [36.0%]; P < .001), was higher in the control group. There was only 1 case of severe hypothermia, which occurred in the plastic group in a neonate weighing 840 g at birth.
Neonates wrapped in polyethylene occlusive covering achieved rapid thermal control and maintained that control compared with infants wrapped in cloths. They also had a decreased incidence of hypothermia for the initial 24 hours of life. Polyethylene occlusive skin wrapping is an inexpensive, effective, and feasible way of thermoregulation. Further research is needed to establish it at scale.
- Copyright © 2015 by the American Academy of Pediatrics