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  • A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

Pediatrics (2013-06-19)
Lisa K McCarthy, Eleanor J Molloy, Anne R Twomey, John F A Murphy, Colm P F O'Donnell
ABSTRACT

Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission. Infants <31 weeks were randomly assigned before birth to treatment with or without an EM. All infants were placed in a PB and under radiant heat immediately after birth and brought to NICU in a transport incubator. Infants randomly assigned to EM were placed on a mattress immediately after delivery and remained on it until admission. Randomization was stratified by gestational age. Rectal temperature was measured with a digital thermometer on NICU admission. The data safety monitoring committee recommended stopping for efficacy after analyzing data from half the planned sample. We report data for 72 infants enrolled at this time. Fewer infants in PBs on EMs had temperatures within the target range (15/37 [41%] vs 27/35 [77%], P = .002) and more had temperatures >37.5°C (17/37 [46%] vs 6/35 [17%], P = .009). In very preterm newborns, using EMs in addition to PBs in the DR resulted in more infants with temperatures outside the normal range and more hyperthermia on NICU admission.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, surface-modified, powder, 125 μm avg. part. size
Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, average Mw 3,000,000-6,000,000
Sigma-Aldrich
Polyethylene, Ultra-high molecular weight, surface-modified, powder, 34-50 μm particle size
Sigma-Aldrich
Polyethylene, low density, melt index 25 g/10 min (190°C/2.16kg)
Sigma-Aldrich
Polyethylene, Linear low density, melt index 1.0 g/10 min (190°C/2.16kg)
Sigma-Aldrich
Polyethylene, High density, melt index 2.2 g/10 min (190 °C/2.16kg)
Supelco
Polyethylene, analytical standard, for GPC, 2,000
Sigma-Aldrich
Polyethylene, High density, melt index 12 g/10 min (190 °C/2.16kg)
Sigma-Aldrich
Polyethylene, Medium density
Sigma-Aldrich
Polyethylene, average Mw ~4,000 by GPC, average Mn ~1,700 by GPC
Polyethylene (LDPE), ERM®, certified reference material