TABLE 29.

Hypothermia Prevention and Management

SourceLocation and Type of TrialInterventionPerinatal/Neonatal Outcome
Gosavi et al493India; urban setting; PCS32 high-risk newborn infants of varying disease severity were transported using the Styropor box.None developed hypothermia (all had temperatures >36.5°C before and after transport). No other complications occurred during the transportation.
Daga et al492India; rural setting; PCS1 normal birth weight infant (2.6 kg) and a LBW infant (1.8 kg) were sequentially studied using KMC and then a Styropor box.The temperature of the 2 infants was comparable using the 2 methods of care.
Johanson et al473Nepal; rural setting; RCTA prospective observational study of postnatal neonatal body temperature was followed by a randomized controlled intervention study using KMC, traditional “oil massage” and a “plastic swaddler.” There were 500 infants in the initial observation study and 300 in the intervention study. In the observation study, 85% (420/495) of infants had temperatures <36°C at 2 h and nearly 50% (198/405) had temperatures <36°C at 24 h (14% were <35°C). Most of the infants who were cold at 24 h had initially become cold at the time of delivery (only 7 infants had been both well-dried and wrapped). In the intervention study, all infants were dried and wrapped before random assignment to 1 of the 3 intervention methods.All 3 methods were found to be equally effective. Overall, 38% (114/298) and 18% (41/231) of the infants had a temperature <36°C at 2 and 24 h, respectively. None were <35°C.
Fernandez et al491India; rural setting; PCS, controls matched for weight and gestational agePreterm babies (n = 25) between 28 and 36 wk gestational age were treated with corn oil applied every 4 h to the entire body. An equal number of preterm infants (n = 25) were matched for weight and gestational age and served as the control group.The study group required the use of the warmer to maintain rectal body temperature for significantly less time (P < .001) than the controls. Serum triglyceride levels also rose significantly (P < .01) in the study group from baseline to 72 h after initiation of treatment.