Neonatal thermoregulation

Temperature control of the newborn infant has been a popular research topic over the last several decades and one that has significantly altered neonatal morbidity and mortality outcomes. Premature infants especially are prone to heat loss by convection, conduction, evaporation and radiation due to their thin skin, decreased body fat and immature body systems. Healthcare providers make temperature regulation one of the most important management issues for newborns, particularly in the case of premature infants. Although term and most premature infants manage their own heat production through non-shivering thermogenesis, healthcare providers need to manage the environment of those infants to minimize heat loss using special environments and procedures. Nursing and medical interventions have improved neonatal thermoregulation; however, hypothermia continues to be a problem in the extremely low birth weight (ELBW) infant population (premature infants born weighing less than 1000 grams). One intervention, placement of infants in polyurethane bags, serves to protect the smallest premature infants from evaporative heat losses in the delivery room. Once ELBW infants are admitted to neonatal intensive care units, stabilization procedures continue to expose infants to cold temperatures. ELBW infants are unable to generate heat due to immature body systems, and body temperatures can fall as low as 33º C. Therefore, nurses must pay close attention to the environment of ELBW infants, to prevent decreases in body temperature. In this way, morbidity and mortality can be decreased for ELBW infants.

Duke Scholars

Author Robin Britt Dail School of Nursing