![]() The survey instrument was a specifically designed online questionnaire. In view of these findings, we conducted a survey to assess routine practices of thermal care and, above all, body temperature targets in very low birth weight infants (VLBWI) among high-level NICUs in Germany, Switzerland, and Austria. Primary incubator settings for temperature and relative humidity were distributed very heterogeneously ( 16). Nevertheless, in a French survey published in 2012 including a total of 186 NICUs it was shown that the variability of thermal management in daily routine was still large and often not adapted to the infants' age and maturity. Practical recommendations on how to adjust the ambient conditions for preterm neonates, in order to provide “thermoneutral care,” are given in relevant textbooks ( 13– 15). Very little, if any, is known about the optimal target body temperature of preterm infants during their stay on the Neonatal Intensive Care Unit (NICU), and its potential influence on long-term outcome parameters such as neurological development. Moreover, the majority of papers on neonatal thermoregulation deal with body temperature on admission or during the first hours of life and its influence on short-term outcome parameters such as mortality ( 5, 6, 11, 12). However, most clinical studies on preterm infants' heat balance have been published decades ago when limitations in neonatology were much greater than they are today ( 7– 10). Some authors suggest to apply the same reference range to preterm infants, too ( 5, 6). For term babies the World Health Organization (WHO) recommends a body temperature range of 36.5–37.5☌ ( 4). In utero, the fetal temperature is higher than the maternal temperature ( 1– 3). However, scientific evidence on what might be the “normal” body temperature in preterm neonates is largely lacking. ![]() Therefore, considerable efforts are made in neonatal care to keep the babies' body temperature in the “normal” range. Both hypo- and hyperthermia are known to negatively affect their short- and long-term outcome. As this is below the intrauterine “breeding temperature” of the fetus, further research on this topic is warranted.īody temperature control is of outmost importance in preterm neonates. ![]() This is a remarkable finding in view of the fact that the body temperature of mammalian fetuses in utero is 0.5–1.0☌ higher than that of the mother.Ĭonclusion: Despite lacking scientific evidence, there is a tacit consensus among high-level NICUs that 37.0☌ is the appropriate body temperature in VLBWI, regardless of gestational age and birth weight. Likewise, the cut-off points for hypo- and hyperthermia were defined very similarly and showed low inter-center variability. However, a uniform target body temperature of 36.99 ± 0.19☌ was chosen for all VLBWI categories. A significant increase in incubator settings (air temperature/relative humidity) with decreasing gestational age and birth weight was reported, according to common textbook recommendations. Results and discussion: Out of 112 (75%) returned questionnaires, 87 (58%) were included into analysis. 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.
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