What are the initial incubator temperatures for an infant nursed naked in an incubator to maintain adequate body temperatures?
33 degrees for a 3 kg infant
34 degrees for a 2 kg infant
35 degrees for a 1 kg infant
Where should a telethermometer probe be placed?
Left side of the abdomen or the back
What is the adequate environmental temperature for a term infant dressed and nursed in a bassinete?
20 degrees (range 18-22)
What is the definition of hypothermia?
Temperature below 35 degrees celcius
How is heat lost?
Conduction
Convection
Evaporation
Radiation
Why is a low birth weight infant prone to hypothermia?
- larger surface area for the body mass
- less subcutaneous tissue white fat
- more evaporative heat loss from thin skin
- inadequate brown fat for non- shivering thermogenesis
- inadequate milk intake
- prone to hypoxia, sepis and hypoglycaemia which disturbs the thermoregulatory system
What may hypothermia lead to in a newborn infant ?
- hypoglycaemia
- respiratory distress
- increased O2 consumption
- hypoxia and resultant metabolic acidosis
- increased energy requirement
- poor weight gain
- bleeding due to DIC
- neonatal Cold injury
- neonatal death
Can a LBW have a normal temperature and suffer from a cold stress?
Excess energy is being used up to maintain a normal Body temperature. Failure to gain weight normally may be the only indication of the cold stress
What are risk factors for neonatal cold injury?
Birth in winter, home delivery, low birth weight
What are clinical features of neonatal cold injury?
Apathy and poor feeding. Cry is feeble and infant is lethargic with depressed reflexes, oliguria and bradycardia. Skin is cold to he touch and the skin temperature is usually below 32 degrees. Looks healthy with a ruddy face. Oedema of the lower limbs may progress to sclerema
What is the treatment for neonatal cold injury?
Rapid rewarming in an incubator (KMC can be used)
IV 10 % dextrose water to prevent hypoglycaemia
Antibiotics in view of high risk of infection
Headbox or nasal prong oxygen during rewarming
What is pyrexia defined as?
Axillary temperature > 37
What are causes of pyrexia?
- incubator or room temperature too high
- lying in direct sunlight or phototherapy
- over dressing the infant or using too many blankets
- dehydration
Infection in a newborn infant usually results in hypothermia
What is the normal abdominal skin temperature and normal axillary temperature?
Abdominal: 36-36.5 degrees celcius
Axillary: 36.5- 37 degrees celcius
