Warming Prior to Heel Stick: Blood Sample Quality and Infant Comfort-A Randomized Controlled Trial.
Ulla List Toennesen1, Helene Kierkegaard, Poul-Erik Kofoed
1Departments of Clinical Biochemistry and Immunology (Ms Toennesen and Drs Kierkegaard, Madsen, and Soerensen) and Pediatrics and Adolescent Medicine (Drs Kofoed, Fenger-Gron, and Noergaard), Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark; and Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Denmark (Drs Kofoed and Madsen).
Summary
Comparing three infant heel-warming methods for capillary blood sampling showed no differences in blood sample quality or infant comfort. However, excessive warming should be avoided to prevent heel skin injuries in neonates.
Area of Science:
- Neonatal care
- Pediatric medicine
- Clinical research
Background:
- Capillary blood sampling via heel stick is standard in neonatal units.
- Heel warming before the procedure is common, but optimal methods lack consensus.
Purpose of the Study:
- To compare glove, gel pack, and blanket warming methods for infant heel sticks.
- To assess effects on blood sample quality and infant comfort.
Main Methods:
- Prospective, double-blind, randomized controlled trial in a neonatal intensive care unit.
- Infants randomized to 1 of 3 warming methods; primary outcome: blood flow velocity.
- Secondary outcomes: hemolysis, COMFORTneo score, skin injuries; correlation of temperature and injury analyzed.
Main Results:
- No significant differences in blood flow velocity, hemolysis, or infant comfort across the 3 warming methods.
- Significant differences in achieved heel skin temperature between methods.
- Higher baseline and post-warming skin temperatures were associated with increased skin injury incidence.
Conclusions:
- Common infant heel-warming methods (glove, gel pack, blanket) yield similar results for blood sample quality and infant comfort.
- Avoid excessive heel warming to prevent post-procedure skin injuries in infants.
- Further research may explore optimal temperature ranges to balance efficacy and safety.
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