Hypothermia is defined as a core temperature <35 to 35.5 ° C. They may be purely environment related or occur in the context of a disease. The treatment is effected by heating and correction of the cause.
The normal rectal temperature in infants who were born in the regulation time or earlier is 36.5 to 37.5 ° C. Although hypothermia is a core temperature of <35 to 35.5 ° C, there is cold stress at higher temperatures when the heat loss requires an increase in metabolic heat production.
Hypothermia is defined as a core temperature <35 to 35.5 ° C. They may be purely environment related or occur in the context of a disease. The treatment is effected by heating and correction of the cause. The normal rectal temperature in infants who were born in the regulation time or earlier is 36.5 to 37.5 ° C. Although hypothermia is a core temperature of <35 to 35.5 ° C, there is cold stress at higher temperatures when the heat loss requires an increase in metabolic heat production. The pathophysiology of thermal equilibrium is affected by the relative humidity, air movement, the near cold surfaces and the room temperature. Newborns are susceptible to rapid heat loss and hypothermia because they have a large body surface area compared to the weight, which is true especially for newborns with low birth weight. If the bare skin exposed to environment with cooler objects, there is a loss of heat via radiant heat. Heat loss through evaporation occurs when newborns through the amniotic fluid is still wet. Conductive heat loss occurs when newborns are placed in contact with a cool surface or a cold object. Convective heat loss occurs when a river cool ambient air carries away heat from the newborn. A sustained unnoticed cold stress causes calories used to generate heat and thus the growth is impaired. Newborns have a metabolic response to cooling, which includes a chemical thermogenesis (without shaking) by the sympathetic norepinephrine pours into the brown fat. This special tissue of newborn babies, which is located in the neck between the shoulder blades and around the kidneys and adrenal glands around, reacts with lipolysis and subsequent fatty acid oxidation or -veresterung. These operations serve the local heat production; the ample circulation of brown adipose tissue then provides for the distribution of heat throughout the body. As a result, increase the metabolic rate and the O2 consumption by 2 to 3 times. Therefore, cold stress can lead (premature infants with respiratory distress syndrome z. B.) to tissue hypoxia and neurologic damage in newborns with respiratory depression. The activation of glycogen can cause a transient hyperglycemia. Persistent hypothermia can lead to hypoglycemia and metabolic acidosis and increases the risk of sepsis with late onset and mortality. Despite their compensation mechanisms have newborn babies, especially babies with low birth weight, only limited capabilities for thermoregulation and are prone to a reduced core temperature. Even before the temperature decreases, cold stress occurs when heat loss requires an increase in metabolic heat production. The neutral thermal environment (thermal neutrality) is the optimum temperature range for newborns; it is defined as the ambient temperature, wherein the metabolic demands (and consequently the calorie consumption) to maintain the body temperature in the normal range (36.5 ° to 37.5 ° C rectally) are the lowest. The neutral thermal environment has a narrow scope of 36.7 ° to 37.3 ° C. Hypothermia can etiology by environmental factors, interference affecting thermoregulation (z. B. sepsis [sepsis in neonates], intracranial hemorrhage intracranial haemorrhage] drug withdrawal [Prenatal drug exposure]) or a combination caused. Risk factors of hypothermia maternal hypertension include (hypertension in pregnancy), caesarean section (cesarean section) and low Apgar scores (neonatal resuscitation: Assessment). Reheating treatment in an incubator or under a heat radiator Hypothermia is treated by reheating the child in the incubator or under a radiant heat source. The newborn should be monitored and, if necessary, be treated hypoglycemia, hypoxemia and apnea. Underlying diseases such. As sepsis, a drug rehabilitation or intracranial hemorrhage, need special therapies. Prevention Hypothermia can be in a newborn by rapid drying and subsequent wrapping (including the head) in a warm towel to prevent evaporation, conduction and convective heat loss, bypassed. Premature babies with very low birth weight also benefit from a polyethylene occlusive wrapping for delivery time. If the newborn must be stripped for life support or observation, it should be placed under a heat radiator to avoid radiation losses. Sick newborn must remain in a neutral thermal environment in order to minimize the metabolic rate. The ideal incubator temperature depends on the birth weight, the age of the child and the humidity in the incubator. Alternatively, the temperature can be adjusted via a feedback mechanism so that the skin temperature is 36.5 ° C. Important points newborns, especially infants with very low birth weight, are prone to hypothermia, which is caused by environmental factors; a disease (eg. as intracranial hemorrhage, sepsis) increases the risk. The optimal environment for newborns is that in which the calorie consumption required to maintain normal body temperature is lowest, which is the case usually between 36.7 ° C and 37.3 ° C. Newborns are warmed in an incubator or under a radiant warmer and any underlying findings are discussed. Hypothermia is avoided by rapid drying and then wrapping the newborn.