Abstract
Background: Although thermal care is part of the daily routine in Neonatal Intensive Care Units (NICUs), scientific evidence on what is the appropriate body temperature for very low birth weight infants (VLBWI) is largely lacking.Aim: To find out to what extent the standards of thermal care vary among high-level NICUs, especially with respect to the target body temperature in VLBWI.Methods: An online survey with 21 questions on thermal care in three categories of VLBWI was sent to 149 NICUs in Germany, Switzerland, and Austria.Results and discussion: Out of 112 (75%) returned questionnaires, 87 (58%) were included into analysis. A significant increase in incubator settings (air temperature/relative humidity) with decreasing gestational age and birth weight was reported, according to common textbook recommendations. However, a uniform target body temperature of 36.99 ± 0.19°C was chosen for all VLBWI categories. Likewise, the cut-off points for hypo- and hyperthermia were defined very similarly and showed low inter-center variability. This is a remarkable finding in view of the fact that the body temperature of mammalian fetuses in utero is 0.5–1.0°C higher than that of the mother.Conclusion: Despite lacking scientific evidence, there is a tacit consensus among high-level NICUs that 37.0°C is the appropriate body temperature in VLBWI, regardless of gestational age and birth weight. As this is below the intrauterine “breeding temperature” of the fetus, further research on this topic is warranted.
Highlights
Body temperature control is of outmost importance in preterm neonates
For further specification in the temperature target range and heat therapy devices sections of the survey, the neonates were categorized into three exemplary subgroups according to their gestational age (GA) and birth weight (BW): [1] 30 weeks of gestation (WOG)/1,500 g, [2] 27 WOG/1,000 g, [3] 24 WOG/500 g (Figure 1; cf. Data Sheets 1 and 2 in the Supplementary Material)
Since only two out of six Austrian Neonatal Intensive Care Units (NICUs) returned an answered questionnaire of which one contained an incomplete response, the analysis was confined to German and Swiss centers
Summary
Body temperature control is of outmost importance in preterm neonates. Both hypo- and hyperthermia are known to negatively affect their short- and long-term outcome. Considerable efforts are made in neonatal care to keep the babies’ body temperature in the “normal” range. Scientific evidence on what might be the “normal” body temperature in preterm neonates is largely lacking. For term babies the World Health Organization (WHO) recommends a body temperature range of 36.5–37.5◦C [4]. Thermal care is part of the daily routine in Neonatal Intensive Care Units (NICUs), scientific evidence on what is the appropriate body temperature for very low birth weight infants (VLBWI) is largely lacking
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