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Published on: December 31, 2015
Thermal Blanket to Improve Thermoregulation in Preterm Infants: A Randomized Controlled Trial
Kai-Hsiang Hsu1, Ming-Chou Chiang, Shu-Wen Lin
11Division of Neonatology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital and School of Medicine, Chang-Gung University, Taoyuan, Taiwan. 2Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan. 3Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan. 4Department of Pediatrics Nursing, Linkou Chang Gung Memorial Hospital and School of Medicine, Chang-Gung University, Taoyuan, Taiwan. 5Division of Neurology, Division of Pediatric Critical Care and Emergency Medicine, Department of Pediatrics, Linkou Chang Gung Memorial Hospital and School of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Objective:
To determine the effectiveness of temperature-controlled thermal blanket as additional thermoprotection.
Design:
Randomized controlled prospective study.
Setting:
Single-center tertiary neonatal unit.
Patients:
Inborn very low-birth-weight (< 1,500 g) infants.
Interventions:
Infants were prospectively assigned to thermal blanket group or control at 1:1 ratio. Additional to radiant warmers, a prewarmed blanket of Blanketrol II (Cincinnati Sub-Zero Products, Cincinnati, OH) was applied as mattress for thermal blanket group. The outcomes included temperature and blood pressure changes. We defined hypothermia as temperature less than 36°C and hypotension as mean arterial pressure less than index infant's gestational age in weeks.
Measurements And Main Result:
Total 80 very low-birth-weight infants were allocated, and there was no between-group demographic dissimilarity. At 30th minute, fewer infants in thermal blanket group were hypothermic (43% vs 68%; p = 0.025). These infants had significantly lower prevalence of hypotension, which associated with less dopamine use in the first 6 hours of life (25% vs 50%; p = 0.016). There was no hyperthermia more than 37.5°C episode.
Conclusions:
By using thermal blanket to provide additional thermal protection for very low-birth-weight infants, the degree of hypothermia was improved, which related to fewer hypotensive cases and less dopamine usage.
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