@article {Cavallin572, author = {Francesco Cavallin and Nicoletta Doglioni and Alessandra Allodi and Nadia Battajon and Stefania Vedovato and Letizia Capasso and Eloisa Gitto and Nicola Laforgia and Giulia Paviotti and Maria Grazia Capretti and Camilla Gizzi and Paolo Ernesto Villani and Paolo Biban and Simone Pratesi and Gianluca Lista and Fabrizio Ciralli and Massimo Soffiati and Alex Staffler and Eugenio Baraldi and Daniele Trevisanuto}, editor = {, and , and Raimondi, Francesco and Bastrenta, Petrina and Capozza, Manuela and Torre, Silvia Del and Favero, Valentina and Lama, Silvia and Luzzati, Michele and Marsico, Concetta and Sibona, Irene and Rico, Sonia and Wanker, Petra}, title = {Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study}, volume = {106}, number = {6}, pages = {572--577}, year = {2021}, doi = {10.1136/archdischild-2020-320567}, publisher = {BMJ Publishing Group}, abstract = {Background The thermal servo-controlled systems are routinely used in neonatal intensive care units (NICUs) to accurately manage patient temperature, but their role during the immediate postnatal phase has not been previously assessed.Objective To compare two modalities of thermal management (with and without the use of a servo-controlled system) immediately after birth.Study design and setting Multicentre, unblinded, randomised trial conducted 15 Italian tertiary hospitals.Participants Infants with estimated birth weight \<1500 g and/or gestational age \<30+6 weeks.Intervention Thermal management with or without a thermal servo-controlled system during stabilisation in the delivery room.Primary outcome Proportion of normothermia at NICU admission (axillary temperature 36.5{\textdegree}C{\textendash}37.5{\textdegree}C).Results At NICU admission, normothermia was achieved in 89/225 neonates (39.6\%) with the thermal servo-controlled system and 95/225 neonates (42.2\%) without the thermal servo-controlled system (risk ratio 0.94, 95\% CI 0.75 to 1.17). Thermal servo-controlled system was associated with increased mild hypothermia (36{\textdegree}C{\textendash}36.4{\textdegree}C) (risk ratio 1.48, 95\% CI 1.09 to 2.01).Conclusions In very low birthweight infants, thermal management with the servo-controlled system conferred no advantage in maintaining normothermia at NICU admission, while it was associated with increased mild hypothermia. Thermal management of preterm infants immediately after birth remains a challenge.Trial registration number NCT03844204 Data are available on reasonable request. Data are available on reasonable request to the corresponding author.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/106/6/572}, eprint = {https://fn.bmj.com/content/106/6/572.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }