uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Early Skin-to-Skin Care in Extremely Preterm Infants: Thermal Balance and Care Environment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Perinatal, neonatal och barnkardiologisk forskning, Perinatal, Neonatal and Pediatric Cardiology Research)ORCID iD: 0000-0003-0407-2143
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Perinatal, neonatal och barnkardiologisk forskning/Hellströlm-Westas)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Barnendokrinologisk forskning/Gustafsson)
Show others and affiliations
2012 (English)In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 161, no 3, p. 422-426Article in journal (Refereed) Published
Abstract [en]

Objective

To evaluate infant thermal balance and the physical environment in extremely preterm infants during skin-to-skin care (SSC).

Study design

Measurements were performed in 26 extremely preterm infants (gestational age 22-26 weeks; postnatal age, 2-9 days) during pretest (in incubator), test (during SSC), and posttest (in incubator) periods. Infants' skin temperature and body temperature, ambient temperature, and relative humidity were measured. Evaporimetry was used to determine transepidermal water loss, and insensible water loss through the skin was calculated.

Results

The infants maintained a normal body temperature during SSC. Transfer to and from SSC was associated with a drop in skin temperature, which increased during SSC. Ambient humidity and temperature were lower during SSC than during incubator care. Insensible water loss through the skin was higher during SSC.

Conclusion

SSC can be safely used in extremely preterminfants. SSC can be initiated during the first week of life and is feasible in infants requiring neonatal intensive care, including ventilator treatment. During SSC, the conduction of heat from parent to infant is sufficiently high to compensate for the increase in evaporative and convective heat loss. The increased water loss through the skin during SSC is small and should not affect the infant's fluid balance.

Place, publisher, year, edition, pages
2012. Vol. 161, no 3, p. 422-426
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-182517DOI: 10.1016/j.jpeds.2012.02.034ISI: 000308141700014PubMedID: 22497906OAI: oai:DiVA.org:uu-182517DiVA, id: diva2:560531
Available from: 2012-10-15 Created: 2012-10-11 Last updated: 2018-06-27Bibliographically approved
In thesis
1. Aspects of neonatal intensive care and anesthesia: Thermal balance and respiratory management
Open this publication in new window or tab >>Aspects of neonatal intensive care and anesthesia: Thermal balance and respiratory management
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is based on four articles originating from three studies conducted in the neonatal intensive care unit and the children’s operating deparment at Uppsala University Hospital, Sweden.

The overall aim was to obtain new knowledge about thermal balance and care environment in extremely preterm infants during skin-to-skin care (SSC), evaluate different methods of intraoperative monitoring of carbon dioxide (CO2), and to investigate how different levels of inhaled oxygen affect infants’ oxygenation during anesthesia and surgery. Study I investigated infant thermal balance and the physical environment for extremely preterm infants during SSC. Study II formed part of a prospective study to assess the performance of non-invasive transcutaneous and end-tidal technique to continuously monitor CO2 levels in the infants blood during anesthesia. Study III was a prospective randomized trial to investigate oxygenation during induction of anesthesia with room air versus high fraction (80%) of oxygen in healthy newborn infants.

The infants maintained normal body temperature during SSC. In comparison to care in an incubator, during SSC ambient humidity was lower and insensible water loss through the skin was higher. Compared to blood gas Pco, transcutaneous carbon dioxide monitoring yielded a bias of 0.3 ± 0.7 kPa, and end-tidal technique a bias of -1.9 ± 0.9 kPa. After intubation, saturation measured by pulse oximetry was lower (p < .05) in the group breathing room air than in the group with high oxygen (93% ± 6.7 and 99% ± 1.5). None of the infants spent time below the pre-specified safety oxygen saturation targets to mandate supplemental oxygen.

This thesis provides new knowledge about early initiation of SSC after birth for extremely preterm infants, the results will be useful to guide safe routines for implementation of early SSC. These results suggest that during anesthesia would transcutaneous monitoring of carbon dioxide be beneficial, end-tidal monitoring correlated poorly to blood gas and induction of general anesthesia in newborn infants can be safely performed without the use of high levels of supplemental oxygen. Taken together, this new knowledge has the potential to improve intraoperative respiratory management.

Place, publisher, year, edition, pages
uppsala: Acta Universitatis Upsaliensis, 2018. p. 46
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1475
Keywords
Neonatal, anesthesia, kangaroo-mother-care, skin-to-skin care, carbon dioxide
National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-352668 (URN)978-91-513-0375-8 (ISBN)
Public defence
2018-09-14, Rosensalen, Akademiska sjukhuset Ingång 95/96, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2018-08-24 Created: 2018-06-27 Last updated: 2018-09-07Bibliographically approved

Open Access in DiVA

fulltext(642 kB)60 downloads
File information
File name FULLTEXT01.pdfFile size 642 kBChecksum SHA-512
a1868b399e17c136da126f407019a28f6f797cc78cb8763a4e10a772212193c32037e81016af1643cb301f9ceb55aaf1823438c04c1a6b0f635383023ec8ed85
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Karlsson, VictoriaSjörs, GunnarNyqvist, Kerstin HedbergÅgren, Johan

Search in DiVA

By author/editor
Karlsson, VictoriaSjörs, GunnarNyqvist, Kerstin HedbergÅgren, Johan
By organisation
Anaesthesiology and Intensive CareDepartment of Women's and Children's Health
In the same journal
Journal of Pediatrics
Pediatrics

Search outside of DiVA

GoogleGoogle Scholar
Total: 60 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 679 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf