入院时低温对新生儿的影响

A. Almudeer, Muneerah Najmi, Easa Magfori, Mohd Salwi
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Hypothermia was classified according to WHO definition as mild (36–36.5°C), moderate (32–35.9°C), or severe (32°C) when the temperature dropped below 36.5°C. We used a multivariable logistic regression analysis to investigate the adjusted effect of hypothermia on neonatal mortality and complications The regression analysis results were provided as crude/unadjusted odds ratios (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results: Of the infants included in the dataset Almost half of them (49.3%) had abnormal body temperature, 20.7%, 11.3%, and 17.3% had mild, moderate, and severe hypothermia respectively. Around 20% of newborns were given a bath 2 hours after birth, 36% their head covered with hats, and 21.7% had skin-to-skin contact. 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引用次数: 0

摘要

目的:低温的后果与较高的死亡率和发病率相关,因此,分娩后的热控制是新生儿护理的必要条件。我们决定更多地了解我们单位的热调节程序。本研究的目的是确定新生儿重症监护病房(NICUs)入院时的体温及其与死亡和其他发病率的关系。我们也有兴趣研究新生儿分娩后的干预措施,以控制体温,看看这些干预措施如何影响体温调节。方法:前瞻性队列研究,使用围产期图表回顾数据,对2021年4月至2022年3月期间在吉赞法赫德国王中心医院收治的所有新生儿重症监护室的300名婴儿进行研究。根据世卫组织的定义,低温分为轻度(36-36.5°C)、中度(32 - 35.9°C)和重度(32°C),当温度降至36.5°C以下时。我们使用多变量logistic回归分析来研究低温对新生儿死亡率和并发症的调整效应,回归分析结果以95%置信区间(ci)的粗/未调整优势比(OR)和调整优势比(AOR)提供。结果:在数据集中的婴儿中,近一半(49.3%)的婴儿体温异常,分别为20.7%、11.3%和17.3%的婴儿出现轻度、中度和重度体温过低。约20%的新生儿在出生后2小时洗澡,36%的新生儿戴上帽子,21.7%的新生儿有皮肤接触。调整后的模型发现,新生儿严重低温的发生率为0.53 (OR = 0.53;[95% CI: 0.15-1.83])和2.04 (OR = 2.04;[95% CI: 0.76-5.46])发生并发症的可能性是无低温新生儿的两倍。低出生体重新生儿(OR = 16.5;[95% CI: 1.47-185.7])和无皮肤接触(OR = 3.27;[95% CI: 1.33-8.04])与皮肤接触的患者相比,更容易出现任何并发症。结论:根据这项研究,低温、低出生体重、异常CBC和缺乏皮肤接触都会增加新生儿发病的风险。根据这项研究,在沙特阿拉伯的医院里,戴头巾、皮肤接触和延迟洗澡等热调节技术并不普遍。这些发现要求对这些程序或建议进行审查,并评估新生儿重症监护病房的热调节规则的执行情况。
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The Effect of Admission Hypothermia on Newborn
Objective: Consequences of hypothermia is associated with higher mortality and morbidity therefore, thermal control following delivery is an essential of neonatal care. We decided to learn more about thermal regulating procedures in our unit. The goal of this study was to determine the temperature at the time of admission to our neonatal intensive care units (NICUs) and how it relates to death and other morbidity. We also interested to look into the newborn interventions after delivery to control temperature and see how these interventions affect thermal regulation. Methods: Prospective cohort study using perinatal chart review data for all babies admitted to the NICU at King Fahd central hospital in Jazan. 300 babies through period of April 2021 to March 2022. Hypothermia was classified according to WHO definition as mild (36–36.5°C), moderate (32–35.9°C), or severe (32°C) when the temperature dropped below 36.5°C. We used a multivariable logistic regression analysis to investigate the adjusted effect of hypothermia on neonatal mortality and complications The regression analysis results were provided as crude/unadjusted odds ratios (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results: Of the infants included in the dataset Almost half of them (49.3%) had abnormal body temperature, 20.7%, 11.3%, and 17.3% had mild, moderate, and severe hypothermia respectively. Around 20% of newborns were given a bath 2 hours after birth, 36% their head covered with hats, and 21.7% had skin-to-skin contact. The adjusted model found that newborns with severe hypothermia were 0.53 (OR = 0.53; [95% CI: 0.15-1.83]) times likely to die and 2.04 (OR = 2.04; [95% CI: 0.76-5.46]) times likely to develop any complication when compared to newborns without hypothermia. Newborns with low birth weight (OR = 16.5; [95% CI: 1.47-185.7]) and without skin-to-skin contact (OR = 3.27; [95% CI: 1.33-8.04]) were more likely to develop any complication when compared to those with skin-to-skin contact. Conclusion: Hypothermia, low birth weight, abnormal CBC, and absence of skin-to-skin contact all raise the risk of neonatal morbidity, according to this study. According to the study, thermal regulation techniques such as head coverings, skin-to-skin contact, and delayed bathing are not widespread in Saudi Arabian hospitals. These findings call for a review of the procedures or recommendations, as well as an assessment of how well the thermal regulation rules are being followed in NICUs.
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