Impact of Delivery Room Resuscitation Efforts on Admission Temperatures in Infants Born < 32 Weeks Gestation

Darjan Kardum*; Boris Filipović Grčić; Andrijana Muller; Damir Lončarević

doi:10.26332/seemedj.v2i1.70

Darjan Kardum* Faculty of Medicine, Josip Juraj Strossmayer University of Osijek; Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital Osijek, Croatia
Boris Filipović Grčić School of Medicine, University of Zagreb; Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital Centre Zagreb, Croatia
Andrijana Muller Faculty of Medicine, Josip Juraj Strossmayer University of Osijek; Department of Gynecology and Obstetrics, University Hospital Osijek, Croatia
Damir Lončarević Neonatal Intensive Care Unit, Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, Croatia

DOI: https://doi.org/10.26332/seemedj.v2i1.70

Abstract

Aim: This study aimed to determine how delivery room resuscitation efforts influence admission temperatures in premature infants born before 32 weeks gestation.

Methods: We retrospectively analyzed a cohort of premature infants born before 32 weeks gestation from January 2014 until December 2016. We compared the impact of resuscitation efforts performed in the delivery room on the admission temperature. Hypothermia was defined as a core temperature of less than 36.5°C on admission. The primary outcome was admission temperature in the Neonatal Intensive Care Unit. Secondary outcomes were Apgar scores in the first and fifth minute, pH on admission, respiratory distress syndrome requiring surfactant, persistent ductus arteriosus, necrotizing enterocolitis, late onset sepsis, kidney failure, intraventricular hemorrhage and death until hospital discharge. Exclusion criteria were chromosomal abnormalities, large congenital anomalies and etc.

Results: We studied 147 infants born < 32 weeks gestation. In the delivery room 66 (44.8%) of infants were given standard thermal care, 20 (13.6%) received standard care and CPAP, 49 (33.3%) received standard care and IPPV and 12 (8.1%) of infants received standard care and extensive resuscitation efforts (intubation and/or chest compressions and/or epinephrine). Patients receiving standard care and IPPV had significantly lower admission temperatures than those given standard care only (35.7°C vs. 36.2 °C, p < 0.02). No correlation was found in infants receiving CPAP or extensive resuscitation efforts compared to those receiving standard thermal care only.

Conclusion: In our study the admission hypothermia was associated with IPPV in the delivery room. Application of CPAP or extensive resuscitation efforts in the delivery room did not influence admission temperatures.