PT  - JOURNAL ARTICLE
AU  - Francesco Cavallin
AU  - Nicoletta Doglioni
AU  - Alessandra Allodi
AU  - Nadia Battajon
AU  - Stefania Vedovato
AU  - Letizia Capasso
AU  - Eloisa Gitto
AU  - Nicola Laforgia
AU  - Giulia Paviotti
AU  - Maria Grazia Capretti
AU  - Camilla Gizzi
AU  - Paolo Ernesto Villani
AU  - Paolo Biban
AU  - Simone Pratesi
AU  - Gianluca Lista
AU  - Fabrizio Ciralli
AU  - Massimo Soffiati
AU  - Alex Staffler
AU  - Eugenio Baraldi
AU  - Daniele Trevisanuto
ED  - ,
TI  - Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study
AID  - 10.1136/archdischild-2020-320567
DP  - 2021 Nov 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - 572--577
VI  - 106
IP  - 6
4099  - http://fn.bmj.com/content/106/6/572.short
4100  - http://fn.bmj.com/content/106/6/572.full
SO  - Arch Dis Child Fetal Neonatal Ed2021 Nov 01; 106
AB  - 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°C–37.5°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°C–36.4°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.