Translated Titles

Reducing the Incidence of Hypothermia in Very Low Birth Weight Premature Newborns




張詩珮(Shih-Pei Chang);蕭君瑋(Jiun-Woei Shiau);曹伯年(Po-NienTsao);鄭之勛(Jih-Shuin Jerng);黃筱芳(Hsiao-Fang Huang);張壁蘭(Pi-Lan Chang);范圭玲(Guei-Ling Fann);陳玉蓮(Yu-Lien Chen)

Key Words

低體重早產兒低體溫發生率 ; 離開產房前低體溫發生率 ; 入住加護病房一小時內低體溫發生率 ; hypothermia ; very low birth weight newborns ; team resource management



Volume or Term/Year and Month of Publication

23卷4期(2019 / 07 / 25)

Page #

488 - 500

Content Language


Chinese Abstract


English Abstract

Hypothermia of very low birth weight (VLBW) preterm babies is associated with increased morbidity and mortality. Maintenance and stabilization of adequate body temperature are vital in this patient population. In this program, we aimed to reduce the incidence of hypothermia in VLBW preterm babies. Investigations showed that the major reasons of the high incidence of hypothermia in this institution included a low-temperature environment of the delivery room, unclear roles, and responsibilities among medical team members, unfamiliarity with the process of preventing hypothermia, insufficient education training and advocacy, and lack of standardized procedure to prevent hypothermia. Improvement strategies included maintenance of higher temperatures surrounding the infant and the transportation route, the provision of Team Resources Management (TRM) training with teaching video, establishment and implementation of a process checklist and prepared kit materials, ongoing education and training, establishment of standardized operation procedures according to current clinical situation, and intensified auditing of the clinical care process of the nurses. The results showed that the incidence of hypothermia before the neonate was leaving the delivery room has improved from 58.8% to 41.7% after the starting of improvement and then even lowered to 5.9% during the post-implementation period. The incidence of hypothermia in the first hour after admission to the neonatal intensive care unit was reduced from 83.3% to 41.7% during improvement and was 5.9% during the post-implementation period. We conclude that the implementation of these strategies in this program reduced the incidence of hypothermia in VLBW newborns effectively and improved the quality of care.

Topic Category 醫藥衛生 > 醫藥衛生綜合
  1. 1. 張瑞幸:極低出生體重早產兒追蹤門診概況。早產兒基金會會訊2012年第83期。Available at http://www.pbf.org.tw/html/download.asp? file=20120915173649.pdf
  2. 2. Vento M, Lista G: Managing preterm infants in the first minutes of life. Paediatr respir rev 2015;16:151-56.
  3. 3. Knobel RB: Role of effective thermoregulation in premature neonates. Res Rep Neonatol2014;4:147-56.
  4. 4. Nosherwan A, Cheung PY, Schmolzer GM: Management of extremely low birth weight infants in delivery room. ClinPerinatol 2017;44:361-75.
  5. 5. te Pas AB, Lopriore E, Dito I, et al: Humidified and heated air during stabilization at birth improves temperature in preterm infants. Pediatrics 2010;125:e1427-32.
  6. 7. Knobel RB, Wimmer JE, Holbert D: Heat loss prevention for preterm infants in the delivery room. J Perinatol 2005;25:304-8.
  7. 8. 黃雅儀、黃靜宜、林秀美等:極早期袋鼠式護理對低體溫新生兒子宮外體溫適應的成效。護理雜誌2006;53:41-8。[Huang YY, Huang CY, Lin SM, et al: Effect of Very Early Kangaroo Care on Extrauterine Temperature Adaptation in Newborn Infants with Hypothermia Problems. J Nursing 2006;53:407-12.
  8. 9. Laptook AR, Watkinson M: Temperature management in the delivery room. Semin Fetal Neonatal Med 2008;13:383-91.
  9. 10. Fawcett K: Preventing admission hypothermia in very low birth weight neonates. Neonatal Netw 2014;33:143-9.
  10. 11. Mank A, van Zanten HA, Meyer MP, et al: Hypothermia in Preterm Infants in the First Hours after Birth: Occurrence, Course and Risk Factors. PloS one 2016;11:e0164817.
  11. 12. Mance MJ: Keeping infants warm: challenges of hypothermia. Adv Neonatal Care 2008;8:6-12.
  12. 13. de Almeida MF, Guinsburg R, Sancho GA, et al: Hypothermia and early neonatal mortality in preterm infants. J Pediatr 2014;164:271-5.
  13. 14. Castrodale V, Rinehart S: The golden hour: improving the stabilization of the very low birth-weight infant. Adv Neonatal Care 2014;14:9-14.
  14. 15. McCall EM, Alderdice F, Halliday HL, et al: Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database Syst Rev 2010;3:Cd004210.
  15. 16. Shafie H, Syed Zakaria SZ, Adli A, et al: Polyethylene versus cotton cap as an adjunct to body wrap in preterm infants. PediatrInt 2017;59:776-80.
  16. 17. Soll RF: Heat loss prevention in neonates. J Perinatol 2008;28:S57-9.
  17. 18. Pinheiro JM, Boynton S, Furdon SA, et al: Use of chemical warming packs during delivery room resuscitation is associated with decreased rates of hypothermia in very low-birth-weight neonates. Adv Neonatal Care 2011;11:357-62.
  18. 19. Harer MW, Vergales B, Cady T, et al: Implementation of a multidisciplinary guideline improves preterm infant admission temperatures. J Perinatol 2017;37:1242-47.
  19. 6. 衛生福利部國民健康署:出生通報統計年報,2015。[Health Promotion Administration, Ministry of Health and Welfare: Statistics of Birth Reporting System, 2015.] https://www.hpa. gov.tw/Pages/Detail.aspx?nodeid=649&pid=1266/Health Promotion Administration, Ministry of Health and Welfare: Statistics of Birth Reporting System, 2015./Accessed August 30, 2016.