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Neonatal Med > Volume 19(1); 2012 > Article
Journal of the Korean Society of Neonatology 2012;19(1):26-31.
DOI: https://doi.org/10.5385/jksn.2012.19.1.26    Published online February 28, 2012.
Effect of Clinical Strategy for Preventing Heat Loss Between 23 And 24 Weeks of Gestation.
Jin Kyu Kim, Se In Seong, Jeong Hee Shin, Ji Mi Jeong, So Yoon Ahn, Eun Sun Kim, Hye Soo Yoo, Jong Hee Hwang, Yu Jin Jung, Ga Won Jeon, Jae Won Shim, Eun Jeong Lee, Yun Sil Chang, Won Soon Park
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
2Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Pediatrics, Paik Hospital, College of Medicine, Inje University, Ilsan, Korea.
4Department of Pediatrics, Paik Hospital, College of Medicine, Inje University, Busan, Korea.
5Department of Pediatrics, Gospel Hospital, College of Medicine, Kosin University, Busan, Korea.
With conventional methods it has been difficult to maintain a normal body temperature in the case of premature infants born between 23 and 24 weeks of gestation (23/24W). The aim of the present study involves the evaluation of the efficacy of novel clinical strategies to prevent the initial symptoms of hypothermia in 23/24W.
We retrospectively analyzed the medical records of all 23/24W who were born and admitted to Samsung Medical Center from January 2007 to July 2010 (Period 1) and from August 2010 to May 2011 (Period 2). Data collected from medical charts included body temperature, admission delay time intervals, blood gas analysis, and estimated insensible water loss(IWL). The measurements from three days after birth were compared to those obtained during period 1 (P1), in which conventional support was applied to infants and period 2 (P2), in which new clinical strategies including 1. Elevation of the environmental temperature of the delivery room 2. NICU baby-wrapping, 3. Decreased delays in time intervals from delivery to admission, and 4. Initiation of procedures following the stabilization of body temperature.
The body temperature upon admission was significantly higher in P2 than P1 (P1 34.7+/-0.9 vs. P2 35.3+/-0.6degrees C, P=0.011). After the initial procedure, following NICU admission, the body temperature was also significantly higher in P2 than in P1 (P1. 34.9+/-0.8 vs. P2 35.5+/-0.4, P<0.001). The IWL of the first and second day was significantly decreased in infants in the P2 group. Subjects in the P2 group demonstrated significantly improved initial blood gas results of base deficits and bicarbonate concentration, as compared to the P1 group.
New strategies for the prevention of hypothermia were beneficial for decreasing the recorded incidence of hypothermia and improving the IWL, and base deficits of the initial blood gas analysis in 23/24W.
Key Words: Hypothermia; Prevention; Infant; Premature
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