Fatores de risco e morbimortalidade associada à hipotermia à admissão na unidade de terapia intensiva neonatal

Abstract

OBJECTIVE: To determine the incidence of hypothermia, risk factors, and outcomes associated with low body temperature upon admission to the neonatal intensive care unit in very low birth weight infants. METHODS: Longitudinal, observational, prospective study. Very low birth weight newborns admitted to a neonatal intensive care unit between October/2017 and September/2018 were included. The dependent variable was axillary temperature upon admission. We calculated the incidence of hypothermia and compared average temperatures with the risk factors and evaluated. Statistical tests: measures of central tendency, relative/absolute frequencies, Kolmogorov-Smirnov, Levene and Student’s t test, considering p <0.05 as significant. RESULTS: 128 very low birth weight newborns were included, with mean weight and gestational age, respectively, 1079.2g and 29 weeks. Of these, 110 (85.9%) had moderate hypothermia, 13 (10.2%) had mild hypothermia and only 5 (3.9%) were normothermic upon admission. The average temperature found was 34.7ºC. The following risk factors remained associated with low temperature upon admission: weight and gestational age, Apgar score and neonatal resuscitation. The associated outcomes were respiratory distress syndrome, use of mechanical ventilation and vasoactive drugs, pulmonary hemorrhage, use of oxygen at 28 days of life, late-onset sepsis, and death. CONCLUSIONS: The incidence of hypothermia found was high and the lowest temperature at admission was associated with higher morbidity and mortality. It is necessary to pay attention to care practices to maintain the temperature of very low birth weight newborns, especially those with lower weights and gestational ages and who need neonatal resuscitation.

Keywords

• hypothermia
• indicators of morbimortality
• risk factors
• very low weight newborn