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Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

BACKGROUND: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C. PURPOSE: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) in...

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Autores principales: Lee, Na Hyun, Nam, Soo Kyung, Lee, Juyoung, Jun, Yong Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Pediatric Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801200/
https://www.ncbi.nlm.nih.gov/pubmed/31122009
http://dx.doi.org/10.3345/kjp.2019.00206
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author Lee, Na Hyun
Nam, Soo Kyung
Lee, Juyoung
Jun, Yong Hoon
author_facet Lee, Na Hyun
Nam, Soo Kyung
Lee, Juyoung
Jun, Yong Hoon
author_sort Lee, Na Hyun
collection PubMed
description BACKGROUND: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C. PURPOSE: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. METHODS: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed. RESULTS: The mean admission temperature was 36.1°C±0.6°C, with a range of 31.9°C to 38.4°C. Approximately 74.1% of infants had an admission hypothermia of <36.5°C. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5°C–37.5°C and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04–1.83), 1.44 (95% CI, 1.05–1.97) and 1.86 (95% CI, 1.22–2.82) for infants with admission temperatures of 36.0°C–36.4°C, 35.0°C–35.9°C, and <35.0°C, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy. CONCLUSION: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.
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spelling pubmed-68012002019-10-29 Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network Lee, Na Hyun Nam, Soo Kyung Lee, Juyoung Jun, Yong Hoon Korean J Pediatr Original Article BACKGROUND: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C. PURPOSE: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. METHODS: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed. RESULTS: The mean admission temperature was 36.1°C±0.6°C, with a range of 31.9°C to 38.4°C. Approximately 74.1% of infants had an admission hypothermia of <36.5°C. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5°C–37.5°C and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04–1.83), 1.44 (95% CI, 1.05–1.97) and 1.86 (95% CI, 1.22–2.82) for infants with admission temperatures of 36.0°C–36.4°C, 35.0°C–35.9°C, and <35.0°C, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy. CONCLUSION: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population. Korean Pediatric Society 2019-10 2019-05-22 /pmc/articles/PMC6801200/ /pubmed/31122009 http://dx.doi.org/10.3345/kjp.2019.00206 Text en Copyright © 2019 by The Korean Pediatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Na Hyun
Nam, Soo Kyung
Lee, Juyoung
Jun, Yong Hoon
Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title_full Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title_fullStr Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title_full_unstemmed Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title_short Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
title_sort clinical impact of admission hypothermia in very low birth weight infants: results from korean neonatal network
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801200/
https://www.ncbi.nlm.nih.gov/pubmed/31122009
http://dx.doi.org/10.3345/kjp.2019.00206
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