Thermal management with and without servo-controlled system in preterm infants immediately after birth: a...

Area of Science:

• Neonatal intensive care
• Pediatric thermoregulation
• Clinical trial methodology

Background:

• Thermal servo-controlled systems are standard in neonatal intensive care units (NICUs) for temperature management.
• The efficacy of these systems during the immediate postnatal period has not been established.
• NCT03844204

Purpose of the Study:

• To compare thermal management with and without servo-controlled systems immediately after birth.
• To assess the impact on normothermia rates in high-risk neonates.

Main Methods:

• Multicenter, unblinded, randomized trial in 15 Italian tertiary hospitals.
• Included infants with birth weight <1500 g or gestational age <30⁺⁶ weeks.
• Intervention involved thermal management with or without a servo-controlled system during delivery room stabilization.

Main Results:

• Normothermia (36.5°C-37.5°C) at NICU admission occurred in 39.6% with servo-controlled systems and 42.2% without (RR 0.94, 95% CI 0.75-1.17).
• Servo-controlled systems were associated with increased mild hypothermia (36°C-36.4°C) (RR 1.48, 95% CI 1.09-2.01).

Conclusions:

• Servo-controlled systems offer no benefit for maintaining normothermia at NICU admission in very low birthweight infants.
• These systems were associated with a higher incidence of mild hypothermia.
• Effective thermal management for preterm infants immediately post-birth remains a significant clinical challenge.