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Using polyethylene plastic bag to prevent moderate hypothermia during transport in very low birth weight infants: a randomized trial

Journal of Perinatology volume 38, pages 332–336 (2018)Cite this article

Subjects

Objective

Hypothermia remains a significant problem among very low birth weight (VLBW) infants. The use of occlusive polyethylene plastic bags immediately after birth has been proven to be effective for preterm infants to reduce hypothermia. This study aims to determine whether placing VLBW infants in plastic bags during transport reduces hypothermia.

Study design

Study infants were randomly assigned to a standard thermoregulation protocol or to a standard thermoregulation protocol with placement of the torso and lower extremities inside a polyethylene plastic bag during transport. The primary outcome measures were axillary temperature before and after transport and the occurrence of moderate hypothermia upon neonatal intensive care unit admission.

Result

The 108 VLBW infants recruited into the study were randomized to the plastic bag (n = 54) group or to standard group (n = 54) and had similar baseline characteristics. VLBW infants in the plastic bag group had a lower rate of moderate hypothermia (3.7 vs 27.8%; risk ratio 0.10; confidence interval 0.02–0.46; P < 0.001) and higher axillary temperatures (36.4 ± 0.4 °C vs 35.9 ± 0.9 °C; P = 0.001) upon NICU admission compared to infants receiving standard care.

Conclusion

Placing VLBW infants in polyethylene plastic bags during transport reduces the occurrence of hypothermia, especially moderate hypothermia.

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References

  1. Lyon AJ, Freer Y. Goals and options in keeping preterm babies warm. Arch Dis Child Fetal Neonatal Ed. 2011;96:F71–F74.

    Article  PubMed  CAS  Google Scholar 

  2. Kumar V, Shearer JC, Kumar A, Darmstadt GL. Neonatal hypothermia in low resource settings: a review. J Perinatol. 2009;29:401–12.

    Article  PubMed  CAS  Google Scholar 

  3. World Health Organization, Department of Reproductive Health and Research. Thermal protection of the newborn: A practical guide. Geneva, Switzerland: World Health Organization; 1997.

    Google Scholar 

  4. McCall EM, Alderdice F, Halliday HL, Jenkins JG, Vohra S. Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database Syst Rev 2010;(1):CD004210.

  5. Li S, Guo P, Zou Q, He F, Xu F, Tan L. Efficacy and safety of plastic wrap for prevention of hypothermia after birth and during NICU in preterm infants: a systematic review and meta-analysis. PLoS ONE. 2016;11:e0156960.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Carroll PD, Nankervis CA, Giannone PJ, Cordero L. Use of polyethylene bags in extremely low birth weight infant resuscitation for the prevention of hypothermia. J Reprod Med. 2010;55:9–13.

    PubMed  Google Scholar 

  7. Cramer K, Wiebe N, Hartling L, Crumley E, Vohra S. Heat loss prevention: a systematic review of occlusive skin wrap for premature neonates. J Perinatol. 2005;25:763–9.

    Article  PubMed  Google Scholar 

  8. Conde-Agudelo A, Diaz-Rossello JL, Belizan JM. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2011;(4):CD002771.

  9. McCarthy LK, Molloy EJ, Twomey AR, Murphy JF, O’Donnell CP. A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags. Pediatrics. 2013;132:e135–e141.

    Article  PubMed  Google Scholar 

  10. Trevisanuto D, Doglioni N, Cavallin F, Parotto M, Micaglio M, Zanardo V. Heat loss prevention in very preterm infants in delivery rooms: a prospective, randomized, controlled trial of polyethylene caps. J Pediatr. 2010;156:914–7.

    Article  PubMed  Google Scholar 

  11. Leadford AE, Warren JB, Manasyan A, Chomba E, Salas AA, Schelonka R, et al. Plastic bags for prevention of hypothermia in preterm and low birth weight infants. Pediatrics. 2013;132:e128–e134.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Knobel RB, Wimmer JE, Holbert D Jr.. Heat loss prevention for preterm infants in the delivery room. J Perinatol. 2005;25:304–8.

    Article  PubMed  Google Scholar 

  13. de Almeida MF, Guinsburg R, Sancho GA, Rosa IR, Lamy ZC, Martinez FE, et al. Hypothermia and early neonatal mortality in preterm infants. J Pediatr. 2014;164:271–5.

    Article  PubMed  Google Scholar 

  14. Chitty H, Wyllie J. Importance of maintaining the newly born temperature in the normal range from delivery to admission. Semin Fetal Neonatal Med. 2013;18:362–8.

    Article  PubMed  Google Scholar 

  15. Demauro SB, Douglas E, Karp K, Schmidt B, Patel J, Kronberger A, et al. Improving delivery room management for very preterm infants. Pediatrics. 2013;132:e1018–e1025.

    Article  PubMed  Google Scholar 

  16. Smith J, Usher K, Alcock G, Buettner P. Application of plastic wrap to improve temperatures in infants born less than 30 weeks gestation: a randomized controlled trial. Neonatal Netw. 2013;32:235–45.

    Article  PubMed  Google Scholar 

  17. Laptook AR, Salhab W, Bhaskar B. Admission temperature of low birth weight infants: predictors and associated morbidities. Pediatrics. 2007;119:e643–e649.

    Article  PubMed  Google Scholar 

  18. Reilly MC, Vohra S, Rac VE, Dunn M, Ferrelli K, Kiss A, et al. Randomized trial of occlusive wrap for heat loss prevention in preterm infants. J Pediatr. 2015;166:262–8.

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the nurses and fellows in the NICU, Children’s Hospital of Fudan University for their help with this project. We thank Conway Niu (Department of Paediatrics and Child Health University of Otago, Wellington) for the help in preparing the manuscript.

Funding

Funding

The Clinical Research Project was supported by the National Key Research and Development Program (2016YFC1000500).

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Children’s Hospital of Fudan University, Shanghai, China

    Xiao-jing Hu, Li Wang, Ru-yi Zheng, Tian-chan Lv, Yu-xia Zhang, Yun Cao & Guo-ying Huang

  2. Shanghai Key Laboratory of Birth Defects, Shanghai, China

    Guo-ying Huang

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  1. Xiao-jing Hu
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Correspondence to Guo-ying Huang.

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Hu, Xj., Wang, L., Zheng, Ry. et al. Using polyethylene plastic bag to prevent moderate hypothermia during transport in very low birth weight infants: a randomized trial. J Perinatol 38, 332–336 (2018). https://doi.org/10.1038/s41372-017-0028-0

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