Recent discussions

  • Amol Joshi

    Methods of recording of temperature in preterm babies (1) 1. Average time taken by conventional clinical thermometer is 3 – 5 minutes. 2. Time taken by an electronic thermometer by axillary skin temperature is lesser and varies with make and temperature of the baby. 3. We need a method to record the temperature which should be simple, rapid, non-invasive, reproducible(2), cost-effective and accurately reflect the neonate's core body temperature (3), preferably without uncovering the baby. In extremely preterm babies, we recommend using food-grade plastic for transport from the labor room to NICU to prevent hypothermia. 4. The infrared tympanic thermometer has been shown to accurately reflect core temperatures when used in a pediatric population aged 6 months to 15 years. The limited data regarding its accuracy in neonates have reported promising results. The tympanic measurements were significantly higher than electronic axillary temperatures by 0.19 to 0.22°C (4). However, only 12 neonates were included within this study and hence larger-scale studies are needed to determine its accuracy in preterm babies. When mid-forehead measurements were compared to electronic axillary thermometry in neonates nursed in incubators, temperatures measured by the two methods did not differ to a clinically significant degree(5). However, a study in healthy preterm neonates compared the axillary with tympanic membrane temperature recordings noted that they are safe, accurate, easy, and comfortable for the baby sites(6). 5. The methods for recording temperature may vary in facility based and community settings and for spot and continuous recording of temperatures. Methods to keep baby warm: A portable, non-electric, ready to use, and air-activated warm blanket that is designed specifically to support premature, low birth weight newborn children to maintain thermoneutral temperature during transport. It gets activated with a exothermic reaction on exposure to air. It is a single use device capable of maintaining warm temperature for 6- 8 hours. Evidence is lacking. https://parisodhana.org/NeoWarm/#home 1. Lei D, Tan K, Malhotra A. Temperature Monitoring Devices in Neonates. Frontiers in Pediatrics. 2021:890. 2. Jirapaet V, Jirapaet K. Comparisons of tympanic membrane, abdominal skin, axillary, and rectal temperature measurements in term and preterm neonates. Nurs Health Sci. (2000) 2:1–8. doi: 10.1046/j.1442-2018.2000.00034.x 3. Bailey J, Rose P. Axillary and tympanic membrane temperature recording in the preterm neonate: a comparative study. J Adv Nurs. (2001) 34:465–74. doi: 10.1046/j.1365-2648.2001.01775.x 4. Weiss ME. Tympanic infrared thermometry for fullterm and preterm neonates. Clin Pediatr. (1991) 30(4 Suppl):42–5; discussion 9. doi: 10.1177/0009922891030004S12 5. Smith J. Are electronic thermometry techniques suitable alternatives to traditional mercury in glass thermometry techniques in the paediatric setting? J Adv Nurs. (1998) 28:1030–9. doi: 10.1046/j.1365-2648.1998.00745.x 6. Bailey J, Rose P. Axillary and tympanic membrane temperature recording in the preterm neonate: a comparative study. Journal of advanced nursing. 2001 May 7;34(4):465-74.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • Rossiclei de Pinheiro

    A manutenção da temperatura do RN é um tem ame constante discussão, entretanto precisamos individualizar cada um conforme a vitalidade. Existem 2 variáveis importantes: A imaturidade do centro termo regulador do pré-termo, além da necessidades de ressuscitação ou não, dificultando a manutenção da temperatura desejada por muito tempo. Nos hospitais Amigo da Criança no Brasil, o passo 4 tem sido um indicador de qualidade, portanto experiência bem-sucedida do contato pele a pele tem mostrado muita relevância e um papel importante no sucesso da amamentação. Nos muito prematuros a decisão de colocar todos no saco plástico já tem sido uma rotina, porém colocar os bebes a termo pode interferir no contato pele a pele e ainda demorar o inicio da respiração.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
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    Prognostication with Point-of-Care Echocardiography during Cardiac Arrest (ALS): Systematic Review
  • Luciane Berti

    I agree with the agent
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • ANA CAVANHA

    It seems reasonable to me to try to use a temperature of 23 degrees Celsius in the delivery room to reduce cases of hypothermia, as it would be a low-cost action.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • Gabriel Variane

    Despite the paucity of evidence, our center recommends that room temperatures of 23oC be used at birth for late preterm ( ≥34 weeks' gestation) and term infants and also that skin to skin care be used immediately after birth. We do not routinely recommend the use of a plastic bag or wrap in addition to skin to skin care in this population, as the risk-benefit of specific interventions is unknown. I agree that studies examining the effectiveness of interventions are necessary to make these treatment recommendations and that standardizing the timing and method of temperature recording for all infants would be an important step.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • Jaqueline Tonelotto

    I agree with recomendation of operating room temperature to 23ºC, we already practice it.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • Jamson Barreto

    Maintenance of temperature in all the newborns, regardless the gestacional age is clearly important. I think that the most effective strategy to avoid low temperatures at the admission in NICUs or postnatal ward must be combined, since the admission of the mother inside the surgical room, maintaining her normothermia, till the control of temperature of the admission rooms or the use of adequate devices to keep the newborn warmed.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • José Roberto Ramos

    Very relevant and difficult topic to comment on. I believe there are 2 important variables in addition to all those mentioned: different preterm and term physiologies and resuscitation needs or not, making it difficult to maintain the desired temperature for a long time. The successful experience of skin-to-skin contact in Brazil has played an important role and the decision to put all terms in the plastic bag still seems to me to have an uncertain risk-benefit
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
  • Andrea Lube

    Maintaining the proper temperature is a major challenge. We have been practicing golden hour with maintaining skin-to-skin contact for about 1 hour or more. Yet we face problems with colleagues who want a low ambient temperature in these late preterm and especially term deliveries. Maternal temperature is often low, and we don't know how much this can impact the newborn's temperature. We occasionally use gel mattresses. But we are afraid of burning the skin or causing hyperthermia, as we have no control over the temperature of the mattress. The imported thermal mattress is expensive and single-use. The use of plastic bags may help us to maintain the proper temperature.
    In following article:
    Maintaining normal temperature immediately after birth in late preterm and term infants: NLS 5100
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