HEAT LOSS PREVENTION IN THE DELIVERY ROOM

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。体温调节是极不成熟婴儿存活的重要决定因素（即，<28周妊娠）。任何婴儿（足月或早产）的最佳温度范围是最大限度地减少压力和代谢消耗的温度范围。如果婴儿的体温福尔斯降到最佳温度范围的下限以下，则婴儿处于体温过低和任何相关并发症的风险中。有几个风险因素与新生儿体温过低有关，包括感染、凝血异常、产后酸中毒、胎儿循环到新生儿循环的重新调整延迟以及呼吸窘迫综合征等发病率增加。极不成熟的婴儿特别容易热量损失，因为他们缺乏皮下脂肪，具有增加的表面积与体重比，在生命的前两天或三天表现出较差的血管控制，并且具有角质含量相对缺乏的不成熟角质层。为了减少热量损失并因此增加早产儿的存活机会，已经提出并实施了几种创造性的方案和程序。目前，减少出生后热量损失的护理标准是立即在辐射热下干燥新生儿。虽然这种方法已被证明可以显着减少热损失，但仍有相当大的改进空间。这项研究假设，封闭式皮肤包裹的早产儿下预热辐射加热器是更有效的比传统的干燥，以防止死亡率和发病率相关的早产儿体温过低。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Thermoregulation is an important determinant of the survival of very immature infants (i.e., <28 weeks gestation). The optimal temperature range for any infant (term or preterm) is one that minimizes stress and metabolic consumption. If the infant's temperature falls below the lower limit of the optimal temperature range the infant is at risk of hypothermia and any associated complications. Several risk factors are associated with neonatal hypothermia including an increase in morbidity from infection, abnormal coagulation, post-delivery acidosis, delayed readjustment from the fetal to newborn circulation, and respiratory distress syndrome. Very immature infants are particularly vulnerable to heat loss because they lack subcutaneous fat, have an increased surface area to body weight ratio, exhibit poor vasomotor control in the first two or three days of life, and have immature stratum corneum that is relatively deficient in keratin content. In an attempt to reduce heat loss and therefore increase the chances of survival in the premature infant, several inventive protocols and procedures have been proposed and put into practice. Presently, the standard of care for reducing heat loss following birth is to immediately dry newborns under radiant heat. Although this method has been shown to significantly reduce heat loss, there is still considerable room for improvement. This study hypothesizes that occlusive skin wrapping of premature infants under a preheated radiant warmer is more effective than conventional drying for preventing mortality and morbidity related to hypothermia in the premature infant.