ABSTRACT
PURPOSE: With conventional methods it has been difficult to maintain a normal body temperature in the case of premature infants born between 23 and 24 weeks of gestation (23/24W). The aim of the present study involves the evaluation of the efficacy of novel clinical strategies to prevent the initial symptoms of hypothermia in 23/24W. METHODS: We retrospectively analyzed the medical records of all 23/24W who were born and admitted to Samsung Medical Center from January 2007 to July 2010 (Period 1) and from August 2010 to May 2011 (Period 2). Data collected from medical charts included body temperature, admission delay time intervals, blood gas analysis, and estimated insensible water loss(IWL). The measurements from three days after birth were compared to those obtained during period 1 (P1), in which conventional support was applied to infants and period 2 (P2), in which new clinical strategies including 1. Elevation of the environmental temperature of the delivery room 2. NICU baby-wrapping, 3. Decreased delays in time intervals from delivery to admission, and 4. Initiation of procedures following the stabilization of body temperature. RESULTS: The body temperature upon admission was significantly higher in P2 than P1 (P1 34.7+/-0.9 vs. P2 35.3+/-0.6degrees C, P=0.011). After the initial procedure, following NICU admission, the body temperature was also significantly higher in P2 than in P1 (P1. 34.9+/-0.8 vs. P2 35.5+/-0.4, P<0.001). The IWL of the first and second day was significantly decreased in infants in the P2 group. Subjects in the P2 group demonstrated significantly improved initial blood gas results of base deficits and bicarbonate concentration, as compared to the P1 group. CONCLUSION: New strategies for the prevention of hypothermia were beneficial for decreasing the recorded incidence of hypothermia and improving the IWL, and base deficits of the initial blood gas analysis in 23/24W.