RT Journal Article
SR Electronic
T1 Thermal management with and without servo-controlled system in preterm infants immediately after birth: a multicentre, randomised controlled study
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 572
OP 577
DO 10.1136/archdischild-2020-320567
VO 106
IS 6
A1 Francesco Cavallin
A1 Nicoletta Doglioni
A1 Alessandra Allodi
A1 Nadia Battajon
A1 Stefania Vedovato
A1 Letizia Capasso
A1 Eloisa Gitto
A1 Nicola Laforgia
A1 Giulia Paviotti
A1 Maria Grazia Capretti
A1 Camilla Gizzi
A1 Paolo Ernesto Villani
A1 Paolo Biban
A1 Simone Pratesi
A1 Gianluca Lista
A1 Fabrizio Ciralli
A1 Massimo Soffiati
A1 Alex Staffler
A1 Eugenio Baraldi
A1 Daniele Trevisanuto
A1 ,
YR 2021
UL http://fn.bmj.com/content/106/6/572.abstract
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.