Reducing Transitional Hypothermia in Outborn Very Low Birth Weight Infants

作者：Leng, Haiqing; Wang, Haiyan; Lin, Biyun; Cheng, Guoqiang; Wang, Laishuan^*

来源：Neonatology, 2016, 109(1): 31-36.

DOI：10.1159/000438743

• Neonatal intensive care unit
• Very low birth weight
• Hypothermia
• Transportation
• Quality improvement project

Background: Transitional hypothermia (TH) is associated with increased morbidity and mortality in very low birth weight (VLBW) infants worldwide. Objectives: To assess the effect of a quality improvement project (QIP) on outborn TH and the associated mortality/morbidity among VLBW neonates. Methods: We conducted a multi-intervention QIP to reduce TH (<36 degrees C) among outborn VLBW neonates. This cohort study compared a historical group (group I, n = 86) to a prospective group (group II, established after QIP implementation, n = 86). The primary outcome was axillary temperature measured in the delivery room (DR) and upon admission to the neonatal intensive care unit (NICU). Results: The baseline characteristics of the two groups were similar. After introducing the QIP, the mean DR and NICU admission temperatures of the patients rose from 35.5 to 36.1 degrees C and from 34.6 to 36.2 degrees C, respectively (p < 0.01), and the percentage of patients with temperatures < 36 degrees C in the DR and NICU decreased from 80 to 40% and from 81 to 42% (p < 0.01), respectively. Meanwhile, the percentage of patients with a normal temperature in the DR and NICU rose from 20 to 58% and from 19 to 56% (p < 0.01), respectively, which was accompanied by significantly decreased mortality (p < 0.02) and other improvements. Conclusion: Implementation of a QIP resulted in a decrease in the number of moderately hypothermic VLBW neonates and a sustained improvement in normothermia rates during DR stabilization and transfer to the NICU in outborn VLBW neonates.

• 出版日期2016
• 单位复旦大学