1. Liz Langham – Lead nurse NICU Luton Lesley Kilby – ANNP NICU Luton
Thermoregulation Why?
Liz Langham – Lead nurse NICU Luton
Lesley Kilby – ANNP NICU Luton
EOE Neonatal ODN
31 July 2019

2. Aims Present FHC audit findings Challenges
Cold stress in the term and preterm infant
Take home MESSAGE
EOE Neonatal ODN
31 July 2019

3. Audit results Documentation of Temperature
Pre implementation
Post implementation
Documentation of temperature on admission continues to be good
31 July 2019
EOE Neonatal ODN

4. Actual temperature on admission
Pre Implementation
Post Implementation
There continues to be a significant number of infants who are cold below 30 weeks gestation with around 19% of infants being cold whose gestation is above 35.
EOE Neonatal ODN
31 July 2019

5. Delivery room temperatures
Delivery room temperatures were not routinely recorded prior to the implementation of the FHC paperwork
There is a need for improvement with 83.3% of delivery room temperatures not being recorded.
EOE Neonatal ODN
31 July 2019

6. Challenges Delivery suite room temperatures
Cold, wet babies with large surface area
Compromised neonate
Stabilisation
Transportation to NICU
Management of the neutral thermal environment on NICU
Management of temperature control in well babies with mum
EOE Neonatal ODN
31 July 2019

7. Why are we concerned?
Hypothermia can make a well baby sick and a sick baby even sicker.
How do babies cope with cold stress?
EOE Neonatal ODN
31 July 2019

8. Recap on Metabolic acidosis
Aerobic Metabolism
Anaerobic Metabolism

9. How does a term baby cope with cold stress

10. How does a preterm infant cope with cold stress

11. How can we meet these challenges ‘prevention is better than cure’
It starts in delivery suite
Room Temperature <26º associated with lower temps on admission to NNU Knobel, Wimmer, et al., 2005
Warmed resuscitaire with more than 2 towels!
Think about Stabilistion
Good teamwork
Anticipate those at risk of hypothermia

12. Transfer to NNU Is the transport Incubator helpful for short distances
If in plastic bag and transferred on radiant heater ensure
Warmer Sides are up
Hat
Banked and covered in preheated warm towels
Knobel, Wimmer, et al., 2005
EOE Neonatal ODN
31 July 2019

13. The hypothermic infant should be the exception
Compromised /Septic babies
Unavoidable but will require early recognition and management.

14. Cold affects mortality and morbidity rates
Take home message
Prepare and manage environment
Keep baby warm
Monitor babies temperature
Cold affects mortality and morbidity rates
EOE Neonatal ODN
31 July 2019

15. References
McCall, E., Alderdice, F., Halliday, H., Jenkins, J., & Vohra, S. (2010) Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD DOI: /
Karlsen K., S.T.A.B.L.E. Post resuscitation Pre transport stabilisation of the New Born manual (Thermoregulation module) 6th edition
Knobel, R. & Holditch-Davis, D. (2007) Thermoregulation and Heat Loss Prevention After Birth and During Neonatal Intensive-Care Unit Stabilization of Extremely Low-Birthweight Infants. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 36, 3,
Knobel, R., Wimmer, J., & Holbert, D. (2005). Heat loss prevention for preterm infants in the delivery room. Journal of Perinatology, 25,

16. EOE Neonatal ODN
31 July 2019

17. EOE Neonatal ODN
31 July 2019