Download PDF
Z Geburtshilfe Neonatol 2013; 217(06): 220-224
DOI: 10.1055/s-0033-1361175
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Thermoregulation of Premature Infants during and after Skin-to-Skin Care

Thermoregulation von Frühgeborenen vor und nach dem Kangarooing
K. Heimann
1   University Children’s Hospital, RWTH Aachen University, Aachen, Germany
,
A. M. Ebert
1   University Children’s Hospital, RWTH Aachen University, Aachen, Germany
,
A. K. Abbas
2   Philips Chair of Medical Information Technology, RWTH Aachen University, Aachen, Germany
,
N. Heussen
3   Department of Medical Statistics, RWTH Aachen University, Aachen, Germany
,
S. Leonhardt
2   Philips Chair of Medical Information Technology, RWTH Aachen University, Aachen, Germany
,
T. Orlikowsky
1   University Children’s Hospital, RWTH Aachen University, Aachen, Germany
› Author Affiliations
Further Information

Publication History

received 17 September 2013

accepted 19 November 2013

Publication Date:
07 January 2014 (online)

Also available at
    Permissions and Reprints

Abstract

Objective:

Providing normothermia is an important issue in daily routine care of premature neonates. We recently found with infrared thermography (IRT) a drop in skin temperature of premature babies after they were positioned from skin-to-skin care (SSC) back into the incubator. Since this did not disappear within 10 min, we wanted to find out how long it takes until the baby has fully warmed up after SSC and if the IRT measurements correlate with conventional rectal temperature?

Study design:

A prospective observational study was undertaken with 5 premature infants [3 male, median gestational age 28 weeks (25–29), median age at study 34 d (28–52), median birth weight 898 g (400–1 095), median weight at study 1 263 g (790–1 465)], temperature was determined with IRT (leg, back, arm, head, upper abdomen; diameter 1 cm, scale 0.00°C), comparison with 2 conventional sensors and rectal temperature. Temperatures were recorded every 2 min and displayed for 4 time points, namely at the beginning and the end of skin-to-skin care (SSC1, SSC2), as well as at the beginning and the end of a subsequent 60 min incubator period (I).

Results:

A significant rise during SSC occurred while the cooling after SSC persisted during the complete incubator measurement time (I; p<0.05). Rectal temperature remained stable through the whole measuring period.

Conclusion:

While SSC in our setting led to an increase in temperature, the lack of compensation of peripheral heat loss in the incubator after 60 min may express an inadequate peripheral regulation of body temperature. This should be taken into account before routine care after SSC.

Zusammenfassung

Hintergrund:

Die Sicherstellung der Normothermie ist wesentlicher Bestandteil der Versorgung Frühgeborener. Wir konnten mittels Infrarotthermografie (IRT) zeigen, dass Frühgeborene nachdem sie im Anschluss an das Kangarooing in den Inkubator zurückgelegt wurden, einen signifikanten Abfall der Hauttemperatur aufwiesen. Da innerhalb von 10 min keine Erwärmung stattfand, wollten wir herausfinden, wie lange ein Frühgeborenes zur Wiedererwärmung benötigt und ob die IRT-Messungen mit der rektalen Temperatur korrelieren?

Studiendesign:

Prospektive Beobachtungsstudie bei 5 Frühgeborenen [3 männlich, Median Gestationsalter 28 SSW (25–29), Median Geburtsgewicht 898 g (400–1 095), Median Gewicht zum Untersuchungszeitpunkt 1 263 g (790–1 465)] Messung der Temperatur mittels IRT (Bein, Rücken, Arm, Kopf, Oberbauch; Durchmesser 1 cm, Skala 0,00°C), Vergleich mit 2 konventionellen Temperatursensoren und rektaler Temperatur. Die Temperatur wurde alle 2 min registriert und zu 4 Zeitpunkten angegeben: Zu Beginn und am Ende des Kangarooings (K1, K2) sowie am Anfang und am Ende der abschließenden 60-minütigen Inkubatorphase (I).

Ergebnisse:

Es trat ein signifikanter Temperaturanstieg beim Kangarooing auf, während ein unmittelbarer Abfall nach dem Kangarooing während der kompletten anschließenden Inkubatorphase erfolgte (I; p<0,05). Die rektale ­Temperatur blieb während des gesamten Unter­suchungszeitraumes stabil.

Schlussfolgerung:

Während Kangarooing in unserem Versuchsaufbau zu einem Temperaturanstieg führte, ist die fehlende Kompensation des peripheren Wärmeverlustes möglicherweise Ausdruck einer inadäquaten peripheren Regulation der Körpertemperatur. Dies sollte vor Durchführung von Routinemaßnahmen nach dem Kangarooing bedacht werden.

Key words

infrared thermography - skin-to-skin care - thermoregulation - body temperature

Schlüsselwörter

Infrarot-Thermografie - Kangarooing - Thermoregulation - Körpertemperatur

Condensed Content

 

  • References

  • 1 Mok Q, Bass C, Ducker D et al. Temperature instability during nursing procedures in preterm neonates. Arch Dis Child 1991; 66: 783-786
    CrossrefPubMedGoogle Scholar
  • 2 Abbas A, Heimann K, Jergus K et al. Neonatal Infrared Thermography Imaging. In: Chen W, Oetomo SB, Feijs L. (eds.) Neonatal Monitoring Technologies: Design for Integrated Solutions. IGI Global; 2012: 84-124
    CrossrefGoogle Scholar
  • 3 Frankenberger RT, Bussmann O, Nahm W et al. Measuring lateral skin temperature profiles of preterm infants in incubators by thermography. Biomed Technik 1998; 43: 174-178
    CrossrefPubMedGoogle Scholar
  • 4 Knobel RB, Geunther BD, Rice HE. Thermoregulation and thermography in neonatal physiology and disease. Biol Res Nurs 2011; 13: 274-282
    CrossrefPubMedGoogle Scholar
  • 5 Knobel RB, Holditch-Davies D, Schwartz TA et al. Extremely low birth weight preterm infants lack vasomotor response in relationship to cold body temperatures. J Perinatol 2009; 29: 814-821
    CrossrefPubMedGoogle Scholar
  • 6 Heimann K, Jergus K, Abbas A et al. Infrared thermography for detailed registration of thermoregulation in premature infants. J Perinat Med 2013; 1-8 DOI: 10.1515/jpm-2012-0239. [Epub ahead of print]
    PubMedGoogle Scholar
  • 7 Heimann K, Vaeßen P, Peschgens T et al. Impact of skin to skin care, prone and supine positioning on cardiorespiratory parameters and thermoregulation in premature infants. Neonatology 2010; 97: 311-317
    CrossrefPubMedGoogle Scholar
  • 8 Bohnhorst B, Gill D, Dördelmann M et al. Bradycardia and desaturation during skin-to-skin care: no relationship to hyperthermia. J Pediatr 2004; 145: 499-502
    PubMedGoogle Scholar
  • 9 Bohnhorst B. Skin to skin care in the neonatal intensive care unit: More data regarding seriously ill infants are badly needed. Neonatology 2010; 97: 318-320
    CrossrefPubMedGoogle Scholar
  • 10 Vohra S, Roberts RS, Zhang B et al. Heat loss prevention (HeLP) in the delivery room: A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants. J Pediatr 2004; 145: 750-753
    CrossrefPubMedGoogle Scholar
  • 11 Tessier R, Cristo M, Velez S et al. Kangaroo mother care and the bonding hypothesis. Pediatrics 1998; 102: 1-8
    CrossrefPubMedGoogle Scholar