1444 OPTIMAL THERMAL MANAGEMENT FOR LOW BIRTH WEIGHT INFANTS NURSED UNDER HIGH-POWER RADIANT WARMERS

Abstract

Radiant warmers positioned over open bed platforms provide continuous thermal maintenance while allowing ready access to critically ill infants. There are no studies defining a thermoneutral temperature using high-output radiant warmers servocontrolled to anterior abdominal wall skin temperature (Tabd). To determine thermoneutral temperature, 17 low birthweight infants recovering from respiratory distress syndrome (BW 1.28 ± .25 kg, EGA 30.7 ± 1.9 wk, age at study 7.5 ± 3.7 days) (mean ± SD) were studied. Oxygen consumption (VO2, ml/kg/min) was measured continuously using open-circuit technique for 90 minute study periods at 35.5°, 36.5° and 37.5° C servocontrolled TaoH. Mean skin (Tsk) and rectal temperatures (TR), heart rate (HR bpm) and % sleep time were also monitored. Results are summarized below.Nine infants had TR > 37.5° and 3 had TR ≥ 38.0° when servocontrolled to Tabd 37.5°C. There was a trend to decreased activity at higher temperatures. 36.5°C was a well-tolerated Tabd control-point with a minimal VO2 without risk of core hyperthermia. A control-point of 37.5°C should not be used because of the risk of hyperthermia.