• Bouchra Agourram, Véronique Bach, Pierre Tourneux, Gérard Krim, Stéphane Delanaud, and Jean-Pierre Libert.
• PériTox-INERIS EA4285 UMI 01, Faculté de Médecine, Université de Picardie Jules Verne, 3 Rue des Louvels, and Médecine Néonatale, Centre Hospitalier Universitaire Nord, F-80036 Amiens, France.
• J. Appl. Physiol. 2010 Jun 1; 108 (6): 1674-81.

AbstractWrapping low-birth-weight neonates in a plastic bag prevents body heat loss. A bonnet can also be used, since large amounts of heat can be lost from the head region, but may provide too much thermal insulation, thus increasing the risk of overheating. We assessed the time required to reach warning body temperature (t38 degrees C), heat stroke (t40 degrees C), or extreme value (t43 degrees C) in a mathematical model that involved calculating various local body heat losses. Simulated heat exchanges were based on body surface temperature distribution measured in preterm neonates exposed to 33 degrees C air temperature (relative air humidity: 35%; air velocity: <0.1 m/s) and covered (torso and limbs) or not with a transparent plastic bag. We also compared metabolic heat production with body heat losses when a bonnet (2 or 3.5 mm thick) covered 10%, 40%, or 100% of the head. Wrapping neonates in a bag (combined or not with a bonnet) does not induce a critical situation as long as metabolic heat production does not increase. When endogenous heat production rises, t38 degrees C ranged between 75 and 287, t40 degrees C between 185 and 549, and t43 degrees C between 287 and 702 min. When this increase was accompanied by a fall in skin temperature, overheating risk was accentuated (37

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