Health  Vol.5 No.8 D , August 2013
Does the incubator control mode influence outcomes of low-birth-weight neonates during the first days of life and at hospital discharge?
ABSTRACT

Background: The thermal environment surrounding neonates in closed incubators can be regulated via two different modes: skin servocontrol mode (SSC) and air temperature control mode (ATC). These produce different patterns of incubator air and infant body temperatures. Objective: To assess the effects of incubator control mode on clinical outcomes of low-birth-weight-infants during the first days of life and at hospital discharge. Methods: 52 low-birth-weight neonates were nursed over ten days in closed incubators functioning either with SSC mode (n = 29), or with ATC mode (n = 23). Results: The anthropomorphic characteristics of the two groups of neonates were homogenous (gestational age = 29.4 ± 1.4 vs. 29.9 ± 1.2 weeks and birthweight = 1214 ± 347 vs. 1263 ±292 gin the SSC-group and the ATC-group, respectively) and the caregiving (energy and fluid intakes, ventilator assistance and drug administration) did not differ statistically. Daily means of incubator air temperature were similar in the SSC and the ATC-group, however, the SSC mode resulted in more variable incubator air temperature but more stable skin abdominal temperature whereas the reverse was found when using the ATC mode. Those differences had no impact on the body weight of the neonates or their clinical outcomes at hospital discharge which were not statistically different. Conclusion: The clinical outcomes do not differ depending on the incubator control mode after the first ten days of life and at hospital discharge.


Cite this paper
Décima, P. , Stéphan-Blanchard, E. , Léké, A. , Dégrugilliers, L. , Delanaud, S. , Libert, J. and Tourneux, P. (2013) Does the incubator control mode influence outcomes of low-birth-weight neonates during the first days of life and at hospital discharge?. Health, 5, 6-13. doi: 10.4236/health.2013.58A4002.
References
[1]   Dollberg, S., Demarini, S., Donovan, E.F. and Hoath, S.B. (2000) Maturation of thermal capabilities in preterm infants. Journal of Perinatology, 17, 47-51.

[2]   Glass, L., Silverman, W.A. and Sinclair, J.C. (1968) Effect of thermal environment on cold resistance and growth of small infants after the first week of life. Pediatrics, 41, 1033-1046.

[3]   Thomas, K.A. and Burr, R. (1999) Preterm infant thermal care: Differing thermal environments produced by air versus skin servo-control incubators. Journal of Perinatology, 19, 264-270.

[4]   Chessex, P., Blovet, S. and Vaucher J. (1988) Environmental control in very low birth weight infants (less than 1000 grams) cared for in double walled incubators. Journal of Pediatrics, 113, 373-380.

[5]   Heim, T. (1981) Homeothermy and its metabolic cost. In: Davis and Dobbing, Eds., Scientific Foundations of Paediatrics, Heinemann, London, 91-128.

[6]   Richardson, D.K., Shah, B.L., Frantz, I.D., Bednarek, F., Rubin, L.P. and McCormick, M.C. (1999) Perinatal risk and severity of illness in newborns at 6 neonatal intensive care units. The American Journal of the Medical Sciences, 89, 511-516.

[7]   Sinclair, J.C. (2008) Servo-control for maintaining abdominal skin temperature at 361C in low birth weight infants. Cochrane Database of Systematic Reviews, 2, Article ID: CD001074.

[8]   Buetow, K.C. and Klein, S.W. (1964) Effect of maintenance of “normal” skin temperature on survival of infants of low birth weight. Pediatrics, 34, 163-170.

[9]   Day, R.L., Caliguiri, L., Kamenski, C. and Ehrlich, F. (1964) Body temperature and survival of premature infants. Pediatrics, 34, 171-181.

[10]   World Health Organization (2008) Thermal protection of the newborn. A practical guide WHO. Department of Reproductive Health and Research (RHR), Geneva.

[11]   Décima, P., Dégrugilliers, L., Delanaud, S., Stéphan-Blanchard, E., Vanhée, J.L. and Libert, J.P. (2012) Design of a software for assessing thermoneutrality in closed incubators for preterm neonates (PRETHERM project). IRBM, 33, 48-54.

[12]   Chessex, P., Reichman, B.L., Verellen, G.J., Putet, G., Smith, J.M., Heim, T. and Swyer, P.R. (1981) Influence of postnatal age, energy intake, and weight gain on energy metabolism in the very low-birth-weight infant. Journal of Pediatrics, 99, 761-766.

[13]   Narendran, V. and Hoath, S.B. (1999) Thermal management of the low birth weight infant: A cornerstone of neonatology. Journal of Pediatrics, 134, 529-531.

[14]   Graven, S.N., Bowen, F.W., Brooten, D., Eaton, A., Graven, M.N., Hack, M., Hall, L.A., Hansen, N., Hurt, H., Kavalhuna, R., et al. (1992) The high-risk infant environment. Part 1. The role of the neonatal intensive care unit in the outcome of highrisk infants. Journal of Perinatology, 12, 164-172.

[15]   Deguines, C., Décima, P., Pelletier, A., Dégrugilliers, L., Ghyselen, L. and Tourneux, P. (2012) Variations in incubator temperature and humidity management: A survey of current practice. Acta Paediatrica, 101, 230-235.

[16]   Ducker, D.A., Lyon, A.J., Roussel, R.R., Bass, C.A. and Mc Intosh, N. (1985) Incubator temperture control on the very-low-birth-weight infants. Archives of Disease in Childhood, 60, 902-907.

[17]   Bell, E.F. and Rios, G.R. (1983) Air versus skin temperature servocontrol of infant incubators. Journal of Pediatrics, 103, 954-959.

[18]   Perlstein, P.H., Edwards, N.K. and Sutherland, J.M. (1970) Apnea in premature infants and incubator-air-temperature changes. The New England Journal of Medicine, 282, 461-466.

[19]   Thomas, K.A. (2003) Preterm infant thermal responses to caregiving differ by incubator control mode. Journal of Perinatology, 23, 640-645.

[20]   Deguines, C., Dégrugilliers, L., Ghyselen, L., Chardon, K., Bach, V. and Tourneux, P. (2013) Impact of nursing care on temperature environment in preterm newborns nursed in closed convective incubators. Acta Paediatrica, 102, e96-e101.

 
 
Top