Posted on 07/16/2023 7:00:50 PM PDT by ConservativeMind
The percentage of infants from the neonatal intensive care unit (NICU) experiencing hypothermia upon operating room (OR) arrival and at any point during the operation decreased from 48.7% to 6.4% and 67.5% to 37.4%, respectively, after implementation of a multidisciplinary quality improvement project.
About one-third of infants admitted to children's hospitals' NICUs require surgery and are at increased risk for intraoperative hypothermia due to environmental heat loss, anesthesia, and inconsistent temperature monitoring. Hypothermic infants are at risk for infection, excessive bleeding, increased oxygen consumption, the need for cardiorespiratory support, and mortality.
Upon return to the NICU, the percentage of infants experiencing postoperative hypothermia decreased from 5.8% to 2.1% while postoperative hyperthermia increased from 0.8% to 2.6%.
"Intraoperative hypothermia is more prevalent than postoperative hypothermia, yet the problem appears to be recognized less. Several improvement projects have addressed postoperative hypothermia, however, few have focused on reducing intraoperative hypothermia," said Gustave Falciglia, MD, MSCI, MSHQPS.
"The strengths of our project were the large cohort of infants and the use of continuous, secure and automated data to ensure normal temperature for infants before, during and after an operation. Using our current approach, however, further decreasing intraoperative and postoperative hypothermia may not be possible without further increasing postoperative hyperthermia."
Dr. Falciglia and colleagues succeeded in reducing rates of intraoperative hypothermia by standardizing temperature monitoring, the transport process to the OR and intraoperative warming.
"In this project, we used improvement science methodology to understand the barriers to maintaining normal temperature and then to design and implement solutions," said Abbey Studer.
"We found variation in processes contributed to intraoperative hypothermia, so we focused on standardizing temperature monitoring and thermal support during the infant's transport and operation. Automated monitoring using a preoperatively placed continuous temperature probe enhanced providers' situational awareness of infant temperature and guided clinical adjustments."
(Excerpt) Read more at medicalxpress.com ...
Preemie babies have multiple needs, but body heat, warmed blankets, and mother’s breastmilk are very important.
My middle child was two months premature. When I could finally hold her in the NICU, it was a major military maneuver. Between the feeding tube, IVs, oxygen tube, and getting layered down with heated blankets, it took two nurses and myself to position everything. After a half hour in the rocking chair my back began to hurt because I was arched at an odd angle. I didn’t care. I stayed in the chair till my legs went numb, gently and slowly stroking her and rocking, softly singing to her. It was important not to overstimulate her system, so slow and gentle, loving and soothing, were the orders I received and I followed them religiously.
Her good stats jumped substantially and would level up after every visit (I had a toddler at home and came twice a day). They estimated it would take 6 weeks before she could come home. We brought her home after 12 days.
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