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Oct 31, 2018

7th Congress of the European Academy of Paediatric Societies

0491 - DELIVERY ROOM TEMPERATURE AT 74 DEGREE F CAN ACHIEVE NORMOTHERMIA IN EXTREMELY LOW BIRTH WEIGHT (ELBW) INFANTS: MULTIDISCIPLINARY TEAM EFFORT AND CONTINUOUS QUALITY IMPROVEMENT PROJECT

hypothermia

preterm

normothermia

or/dr temperature

hyperthermia

Abstract

Abstract

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Keywords

hypothermia

preterm

normothermia

or/dr temperature

hyperthermia

Abstract

Normothermia (36.5-37.50C) in Extremely Low Birth Weight (ELBW) is associated with decreased morbidity and mortality, length of stay, and costs. There is no consensus about DR/Operating Room (OR) temperature. WHO in 1997 recommended DR/OR temperature of 250C (770F). American Society of Heating, Refrigeration and Air-Conditioning Engineers, Inc., (ASHRAE) in 2011 recommended OR temperature range of 68-750F. NRP in 2016 revised the recommended DR temperature range from 250C to 260C (77-790 F) to 230C to 250C (74-770F). Objective We report the incidence of normothermia over the last four years (2014-2017) while maintaining DR/OR temperature at 230C (740F). Methods We designed a bundle approach that included: education of perinatal and neonatal staff, use of exothermic mattress, saran wrap, pre- heated radiant warmer, head cap, warm towels, and transport of ELBW infants in a servo controlled unit. Axillary temperature every 5 minutes in DR and first temperature within 15 minutes of admission to NICU were recorded. We studied 145 consecutive ELBW cases. Nine infants were <500g and 33 were <24 weeks’ GA. C-Section rate was 76%, and 45% were intubated in OR/DR, 41% were intubated in NICU, 14% did not need intubation, and 3 babies needed epinephrine in the OR/DR. Results Normothermia (36.5-37.50C) was achieved in 88% (128/145) of the ELBW infants. Incidence of hypothermia (<36.50C) was 3.4% (5/145) and hyperthermia (>37.50C) was 8.3% (12/145). Vermont Oxford Network and CPQCC defined Hypothermia as <36.00C. According to this definition, hypothermia rate in our study was 0%. In the last 8 months of 2018, we achieved 100% Normothermia. No case of Hyperthermia. Conclusions: We were able to achieve very close to the target Normothermia rate in the last four consecutive years 2014 to 2017 with OR/DR temperature set at 230C (740F). We suggest OR/DR temperature of 230C (740F) as recommended by ASHRAE and NRP 2016 guidelines without compromising ELBW or VLBW infants’ temperature during the transitional period. One has to be extremely careful to avoid hyperthermia also.

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© Copyright 2019 Morressier GmbH.
All rights reserved.