Treatment
Rewarming in an incubator or under a radiant warmer
Hypothermia is treated by rewarming in an incubator or under a radiant warmer. The neonate should be monitored and treated as needed for hypoglycemia, hypoxemia, and apnea. Underlying conditions such as sepsis, drug withdrawal, or intracranial hemorrhage require specific treatment.
Prevention
Hypothermia can be prevented by immediately drying and then swaddling the neonate (including the head) in a warm blanket to prevent evaporative, conductive, and convective losses. Preterm very-low-birth-weight infants also benefit from a polyethylene occlusive wrapping at the time of delivery. A neonate exposed for resuscitation or observation should be placed under a radiant warmer to prevent radiant losses. Sick neonates should be maintained in a neutral thermal environment to minimize the metabolic rate. The proper incubator temperature varies depending on the neonate’s birth weight and postnatal age, and humidity in the incubator. Alternatively, heating can be adjusted with a servomechanism set to maintain skin temperature at 36.5° C.
Key Points
Neonates, particularly very low-birth-weight infants, are susceptible to environmental hypothermia; illness (eg, intracranial hemorrhage, sepsis) increases risk.
The optimal ambient temperature for neonates is that at which calorie expenditure needed to maintain normal body temperature is lowest, typically between 36.7° C and 37.3° C.
Rewarm neonates in an incubator or under a radiant warmer and treat any underlying conditions.
Prevent hypothermia by immediately drying and then swaddling the neonate.