Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2020-08-01)

Re-assessment of re-warming for out-of-hospital births

  • Peter Jones,
  • Camille Joly,
  • Benoît Vivien

Journal volume & issue
Vol. 28, no. 1
pp. 1 – 2


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Abstract Therapeutic controlled cooling is routinely practiced on neonates with core temperatures of 33–34 °C attained during cooling for birth related hypoxic-ischaemia encephalopathy (HIE). Rewarming after therapeutic cooling in clinical trials for HIE takes place at 0.25–0.5 °C/h over 6–12 h. Javaudin et al. looked at four methods for re-warming infants born out-of-hospital. The incubator group had a 0.8 °C median increase in body temperature for a median transfer time of 38 min (IQR-31-49 min); equating to 1.3 °C/h. In contrast, the group plastic bag+skin-to-skin+cap had a median temperature rise of 0.2 °C (median transport time 43 min [IQR-33-61 min]); equating to 0.28 °C/h, which is closer to therapeutic controlled methods. Javaudin et al. proposed incubator re-warming for out-of-hopital births whereas we consider that an alternative interpretation of the article’s results leads to the different conclusion that plastic bag+skin-to-skin+cap, rather than an incubator, is the preferable method due to the more progressive re-warming and lower frequency of hyperthermia.