Warming the premature infant in the delivery room: Quantification of the risk of hyperthermia

International audienceAim: The efficacy and safety of three polyethylene bags commonly used to prevent hypothermia in premature infants was assessed. Methods: To simulate transfer from the delivery room to a secondary care unit, a thermally stable, bonneted mannequin (skin temperature: 34.4 degrees C) was placed in a climate chamber under different conditions: with a radiant warmer, with various polyethylene bags (open on one side, closed by a draw-string at the neck, or a ``life support pouch'' with several access points) or without a bag. Results: With the radiant warmer turned on, the mean reduction in heat loss from the nude mannequin was 50.8 +/- 1.7% (p <0.0001, vs. warmer off). The mean reduction in heat loss (vs. no bag) was 55.0 +/- 0.9% for the drawstring bag, 49.0 +/- 2.2% for the standard bag (p= 0.0001), and 48.1 +/- 0.7% for the life support pouch (p = 0.006). When a radiant warmer + polyethylene bag were used, heat stress (body temperature: 38 degrees C) and severe hyperthermia (40 degrees C) occurred after 11 and 34 min, respectively. Conclusion: Caution must be taken when using a radiant warmer and polyethylene bag with a prematute infant. Heat stress can occur in only 11 min. Continuous body temperature monitoring is therefore required. (C) 2018 Published by Elsevier Ltd on behalf of IPEM