Definition
Neutral thermal environments (34-35°C or 93.2-95°F) are generally recommended in the context of neonatal resuscitation. (Source 1)
There are four basic mechanisms through which heat is transferred from the newborn to the environment: radiation, conduction, convection and evaporation. (Ref. 1) Nonshivering thermogenesis is the main mechanism of heat production in neonates. A newborn infant left unattended in a room at room temperature experiences energy losses of approximately 150 kcal per min. (Ref. 1)
Effects of Hypothermia on the neonate include : (Source 2)
- Pulmonary vasoconstriction
- Right to left shunt
- Hypoxemia secondary to increased oxygen consumption
- Metabolic acidosis
- Hypoglycemia
Suggested delivery room temperatures by age and weight: (Ref. 2)
- Estimated gestational age (EGA) less than 26 weeks, estimated birth weight (EBW) less than 750 g, or both: 76°F or higher, target 78-80°F
- EGA 27-28 weeks, EBW less than 1000 g, or both: 74°F or higher, target 78-80°F
- EGA 29-32 weeks, EBW 1001-1500 g, or both: 72°F, target 75°F
- EGA 33-36 weeks, EBW 1501-2500 g, or both: 72°F, target 75°F
- EGA 27-42 weeks, EBW greater than 2500 g, or both: 70°F, target 75°F
In most delivery rooms, radiant heat is also delivered by open air warmers to provide the most neutral thermal environment (93.2-95°F).
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Sources
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- Chestnut. Obstetric anesthesia: principles and practice, 3rd Edition. p. 125.
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- Datta, Kodali, Segal. Obstetric Anesthesia Handbook, 5th Edition. p. 236, 2010
PubMed
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R F Soll Heat loss prevention in neonates. J Perinatol: 2008, 28 Suppl 1;S57-9
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D R Bhatt, R White, G Martin, L J Van Marter, N Finer, J P Goldsmith, C Ramos, S Kukreja, R Ramanathan Transitional hypothermia in preterm newborns. J Perinatol: 2007, 27 Suppl 2;S45-7