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Scand J Trauma Resus · Aug 2020
Comment LetterRe-assessment of re-warming for out-of-hospital births.
- Peter Jones, Camille Joly, and Benoît Vivien.
- SAMU de Paris, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, AP-HP, 149 rue de Sèvres, 75015, Paris, France. peter.jones@aphp.fr.
- Scand J Trauma Resus. 2020 Aug 5; 28 (1): 76.
AbstractTherapeutic controlled cooling is routinely practiced on neonates with core temperatures of 33-34 °C attained during cooling for birth related hypoxic-ischaemia encephalopathy (HIE). Rewarming after therapeutic cooling in clinical trials for HIE takes place at 0.25-0.5 °C/h over 6-12 h. Javaudin et al. looked at four methods for re-warming infants born out-of-hospital. The incubator group had a 0.8 °C median increase in body temperature for a median transfer time of 38 min (IQR-31-49 min); equating to 1.3 °C/h. In contrast, the group plastic bag+skin-to-skin+cap had a median temperature rise of 0.2 °C (median transport time 43 min [IQR-33-61 min]); equating to 0.28 °C/h, which is closer to therapeutic controlled methods. Javaudin et al. proposed incubator re-warming for out-of-hopital births whereas we consider that an alternative interpretation of the article's results leads to the different conclusion that plastic bag+skin-to-skin+cap, rather than an incubator, is the preferable method due to the more progressive re-warming and lower frequency of hyperthermia.
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