HEAT LOSS PREVENTION IN THE DELIVERY ROOM

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。体温调节是极不成熟婴儿(即妊娠28周)存活的重要决定因素。任何婴儿(足月儿或早产儿)的最佳温度范围是最大限度地减少压力和新陈代谢消耗。如果婴儿的体温低于最佳温度范围的下限，婴儿就会面临体温过低和任何相关并发症的风险。新生儿体温过低有几个危险因素，包括感染引起的发病率增加、凝血功能异常、产后酸中毒、从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。非常不成熟的婴儿特别容易散热，因为他们缺乏皮下脂肪，表面积与体重的比率增加，在出生的头两三天表现出较差的血管舒缩控制，以及未成熟的角质层相对缺乏角蛋白含量。为了减少热量损失，从而增加早产儿的存活机会，已经提出了几种创造性的方案和程序并付诸实施。目前，减少出生后热量损失的护理标准是在辐射热下立即烘干新生儿。虽然这种方法已被证明可以显著减少热量损失，但仍有相当大的改进空间。本研究假设，在预热辐射加温器下对早产儿进行闭合性皮肤包扎比常规干燥更有效地预防早产儿因体温过低而导致的死亡率和发病率。

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.