Elsevier

The Journal of Pediatrics

Volume 161, Issue 3, September 2012, Pages 422-426
The Journal of Pediatrics

Original Article
Early Skin-to-Skin Care in Extremely Preterm Infants: Thermal Balance and Care Environment

https://doi.org/10.1016/j.jpeds.2012.02.034Get rights and content

Objective

To evaluate infant thermal balance and the physical environment in extremely preterm infants during skin-to-skin care (SSC).

Study design

Measurements were performed in 26 extremely preterm infants (gestational age 22-26 weeks; postnatal age, 2-9 days) during pretest (in incubator), test (during SSC), and posttest (in incubator) periods. Infants' skin temperature and body temperature, ambient temperature, and relative humidity were measured. Evaporimetry was used to determine transepidermal water loss, and insensible water loss through the skin was calculated.

Results

The infants maintained a normal body temperature during SSC. Transfer to and from SSC was associated with a drop in skin temperature, which increased during SSC. Ambient humidity and temperature were lower during SSC than during incubator care. Insensible water loss through the skin was higher during SSC.

Conclusion

SSC can be safely used in extremely preterm infants. SSC can be initiated during the first week of life and is feasible in infants requiring neonatal intensive care, including ventilator treatment. During SSC, the conduction of heat from parent to infant is sufficiently high to compensate for the increase in evaporative and convective heat loss. The increased water loss through the skin during SSC is small and should not affect the infant's fluid balance.

Section snippets

Methods

Infants were eligible for the study who were inborn or admitted after transfer within the first day after birth and born at a gestational age (GA) of <27 weeks. During the 2-year study period, 75 eligible infants were admitted. Twenty-seven infants (GA, 22-26 weeks) were included after parental consent was obtained. Reasons for noninclusion were a parent was unavailable for SSC (n = 4) or an investigator was unavailable for monitoring (n = 44). To verify that our sample was representative,

Infant Temperature

Measurements were performed for a mean SSC duration of 95 minutes (range, 60-180 minutes), at a mean postnatal age of 5 days (range, 2-9 days) (Table I). There was a slight drop in Tbody from pretest to posttest (P < .05; Table II). Tskin displayed several changes during the measurements, including a drop in Tskin when the infant was transferred from the incubator to SSC (P < .001), an increase during SSC (P < .001), and again a slight drop after transfer back to the incubator (P < .05) (

Discussion

We present detailed data on thermal balance and physical care environment during early postnatal SSC of extremely preterm infants receiving neonatal intensive care, including mechanical ventilation. After SSC, the infants maintained their Tbody within the normal range. Transfer of the infant to and from SSC resulted in a drop in infant Tskin, which increased during SSC. The physical environment during SSC is characterized by a lower Tair and relative humidity than during incubator care.

Two

References (16)

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Supported by the Gillbergska Foundation, Uppsala, Sweden. The authors declare no conflicts of interest.

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