Authors (including presenting author) :
Cheng SM(1), Tsoi CHK (1), Ho LP (1), Yeung KY (1)
Affiliation :
(1) Department of Paediatrics, Prince of Wales Hospital
Introduction :
Neonatal hypothermia, defined as a body temperature below 36.5°C, is the leading cause of neonatal morbidity such as intraventricular haemorrhage, late-onset sepsis, hypoglycaemia and mortality, especially in preterm infants. An evidence-based thermal care protocol is applied in PWH NICU since 2022. The developed evidence-based thermal care protocol is effective in improving the temperature in premature infants with less than 32 weeks of gestation after delivery and admission to the NICU. However, there had some room for improvement. For the infants in the <28 weeks group, the mean admission temperature after the introduction of the thermal care protocol was still below 36.5 °C. We need to explore other thermal care strategies, such as humidified and heated air during stabilization of preterm infants in labour ward.
Objectives :
The objective is to implement and evaluate the use of heated and humidified gases in collaboration with the current “thermal care protocol” in the resuscitation of preterm infants born less than 28 weeks gestation on improving the their admission temperature after delivery and admission to the NICU.
Methodology :
Project interventions included the initiation of a heated humidifier in labor ward. This included the purchasing and installation of one new heated circuit attachments for the T-piece resuscitator used at labour ward. Prior to implementation of the protocol, staff were educated to facilitate the application of the heated and humidified gas. A quasi-experimental design study with a historical control group was employed. Data were collected in two periods corresponding to the pre-implementation (control group) from 15/2/2023 to 27/3/2024 and post-implementation (intervention group) from 11/4/2024 to 7/11/2024 to evaluate effectiveness of using heated and humidified gases in the resuscitation of preterm infants.
Result & Outcome :
A total of 37 preterm neonates (20 in the control group and 17 in the intervention group) with gestational age <28 weeks were recruited. There were no statistically significant differences in gestational age, birth weight, mode of delivery, and hence baseline characteristics of infants were similar in the two groups. The admission temperature in the NICU was significantly higher in the intervention group than in the control group [35.9 °C (0.76) vs 36.6 °C (0.58), p<0.05]. The incidence of hypothermia was significantly decreased from 77% to 39% (p<0.05). This project showed that use of heated and humidified gases in collaboration with the current “thermal care protocol” is effective in improving the temperature in premature infants with less than 28 weeks of gestation after delivery and admission to the NICU.
