Related Experiment Video
Updated: May 15, 2026
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Improving admission temperature in extremely low birth weight infants: a hospital-based multi-intervention quality
Zeenia Billimoria1, Sanjay Chawla, Monika Bajaj
1Division of Neonatal Perinatal Medicine, Hutzel Women’s Hospital, Wayne State University, Detroit, MI, USA.
Insights
A quality improvement initiative successfully reduced hypothermia in extremely low birth weight (ELBW) neonates. This multi-intervention approach improved admission temperatures, ensuring more infants remained in the euthermic range without increasing hyperthermia risk.
Area of Science:
- Neonatal Intensive Care
- Pediatric Quality Improvement
- Thermoregulation in Neonates
Background:
- Hypothermia is a significant risk for extremely low birth weight (ELBW) neonates, potentially leading to adverse outcomes.
- Maintaining normothermia is crucial for the survival and well-being of preterm infants.
Purpose of the Study:
- To decrease the incidence of hypothermia (admission temperature <36°C) in extremely low birth weight (ELBW) neonates.
- To implement and evaluate a multi-intervention quality improvement (QI) initiative for neonatal thermal care.
Main Methods:
- A three-period QI initiative was conducted involving changes in drying, wrapping, staff education, warming mattresses, and operating room temperature.
- Interventions were applied to preterm ELBW neonates (≤1000 g) at Hutzel Women's Hospital.
- Statistical analyses included ANOVA, chi-squared tests, and logistic regression to assess outcomes.
Main Results:
- The study included 209 ELBW neonates across three periods.
- The third period of the QI initiative showed a significant increase in admission temperatures and a reduction in hypothermia (P=0.02).
- No hyperthermia (temperature ≥37.5°C) was observed, and surfactant use decreased in the third period.
Conclusions:
- A comprehensive QI approach effectively improved admission temperatures in ELBW neonates, increasing the proportion of euthermic infants.
- The QI initiative enhanced neonatal thermal care without elevating the risk of hyperthermia.
- Improved admission temperatures in ELBW neonates may be linked to better overall outcomes.
Objective:
To reduce the incidence of hypothermia (admission temperatures <36°C) in extremely low birth weight (ELBW) neonates using a multi-intervention quality improvement (QI) initiative.
Study Design:
We conducted a multi-intervention QI initiative to reduce hypothermia (admission temperatures <36°C) among preterm ELBW (≤1000 g birth weight) neonates born at Hutzel Women's Hospital. The QI project was conducted in three periods: period 1, traditional thermal care of drying and wrapping in towel; period 2, wrapping in plastic wrap without first drying; and period 3, periodic staff education, additional use of chemical warming mattress, and increase in operating room temperature from 20°C to 21°C. Statistical analysis included ANOVA, χ2, and logistic regression as appropriate.
Results:
In our cohort of 209 patients, baseline characteristics were comparable in the three periods except for a reduction in the need for surfactant doses in the 3rd period. Temperature on admission to the neonatal intensive care unit was significantly higher, with a reduction in hypothermia in the 3rd period. There was no patient with a temperature of ≥37.5°C. On logistic regression, with gestational age, 5-min Apgar score, and mode of delivery as covariates, time period 3 was significantly associated with a reduction in the incidence of hypothermia (P=0.02).
Conclusion:
A concerted QI approach improved admission temperature in ELBW neonates, with more neonates in the euthermic range, without increasing the risk for hyperthermia. Such an approach could be associated with improved outcomes in this population.
Related Concept Videos
01:29Decreased Body Temperature
01:22Methods of reducing fever
Pharmacological Methods of Reducing Fever:
01:28Factors Affecting Body Temperature
Factors may include:
01:14Temperature Measurement Sites
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
01:19Assessing Body Temperature - Temporal Artery
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
01:27Assessing Body Temperature - Rectal
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...