Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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The survival of very low-birth-weight (VLBW) infants has been shown to be effected by alterations in thermoregulation. Morbidity and mortality in these VLBW infants has remained higher than those in any other group of infants because of their innate vulnerability and because of exposure to risk factors in the environment. This leaves the premature infant vulnerable to cold stress especially in the first hours to weeks of life. ⋯ Hypothermia is a major cause of morbidity and mortality in infants; therefore, maintaining normal body temperatures in the delivery room is crucial. We reviewed evidence related to thermoregulation at birth in VLBW infants, including transepidermal water loss and temperature control in the delivery room, during stabilization and upon admission to the neonatal intensive care unit. Delivery room management that focuses on the adaptation of the infant as well as early interventions that improve long-term outcomes may emphasize the "golden hour" of care and improve outcomes in this extremely vulnerable population.
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Hypothermia remains a significant challenge in the initial care of premature infants. Although a number of prevention strategies have been identified, hypothermia is still a common event, especially in extremely low birth weight infants. ⋯ Increased efforts will be necessary to prevent early hypothermia in very preterm infants, especially with respect to the environmental conditions of the delivery room itself. Journal of Perinatology (2007) 27, S45-S47. doi:10.1038/sj.jp.7211842.
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Extremely low-birthweight infants have inefficient thermoregulation due to immaturity and may exhibit cold body temperatures after birth and during their first 12 hours of life. Hypothermia in these infants can lead to increased morbidity and mortality. Anecdotal notes made during our recent study revealed extremely low-birthweight infants' temperatures decreased with caregiver procedures such as umbilical line insertion, intubations, obtaining chest x-rays, manipulating intravenous lines, repositioning, suctioning, and taking vital signs during the first 12 hours of life. ⋯ Nurses can improve the thermal environment for extremely low-birthweight infants by prewarming the delivery room and placing the infant in a plastic bag up to the neck during delivery room stabilization to prevent heat loss. JOGNN, 36, 280-287; 2007. DOI: 10.1111/J.1552-6909.2007.00149.x.