Maintaining temperature before cord clamping

The journal Archives of Disease in Childhood: Fetal & Neonatal has recently published the results of a clinical trial by Dr Emma Dunne and colleagues in Dublin¹. Delayed (aka deferred) cord clamping (DCC) is now recommended in preterm newborn babies as well as term newborns²

Maintaining a newborn baby’s temperature within a narrow range (36.5 to 37.5 degC) is associated with optimal outcomes, and this information is now routinely collected at admission to NICU. This trial considered the impact upon NICU admission temperature of using a polythene bag prior to DCC vs post-DCC.

Data from 197 births was included in the results, average GA 29 weeks and average weight approximately 1200gms in both groups. Placing a baby in a bag before DCC did not increase the proportion of preterm infants with normal temperature on NICU admission (the primary outcome was rectal temperature within the normal 36.5-37.5 degC range).

The authors noted in the discussion that overall the proportion of abnormal temperatures was high – 35% of the babies were hypothermic on admission into the NICU and 10% were hyperthermic. They observed that in order to avoid overheating a proportion of infants, a more individualised approach to thermal care may be more appropriate. They also commentated that the practice of DCC itself could be placing preterm infants at increased risk of abnormal temperature as it potentially delays placement of the infant under radiant heat and that this study demonstrates that a polythene bag alone will not suffice in maintaining temperature; however, it is reasonable to apply a polythene bag before DCC, as it may facilitate the earlier assessment and any stabilisation measures indicated. Further studies on thermoregulation before DCC are needed.

SurePulse:

These research findings are of particular interest to SurePulse who’s vision is to give clinicians and healthcare providers the tools to provide optimal newborn care. The SurePulse VS Cap is the first SurePulse regulatory approved device, and comprises an optical sensor integrated into a thermo-protective single-use cap which has been designed to provide clinical teams with accurate, reliable, and timely information in the critical moments after birth. SurePulse VS’ wireless approach means that baby’s heart rate can be monitored straight after birth, supporting optimal care during stabilisation and, where necessary, resuscitation.

References: