HeatBalance, a computer program to determine optimum incubator air temperature and humidity. A comparison against nurse settings for infants less than 29 weeks gestation

Abstract

Background: Very immature newborn infants need close control of their thermal environment. Decisions on incubator temperature and humidity settings can be difficult and available charts are not readily applicable to these babies. A computer program (HeatBalance) using basic principles to calculate heat gains and losses has been developed. The program recommends incubator temperature and humidity settings to keep babies in thermal balance.

Aim: The aim of this study was to compare the effect of the program on temperature control of infants <29 weeks gestation with that achieved by experienced nurses.

Method: Twenty consecutive babies were studied over the first 5 days of life, all nursed in incubators using air mode control. The first 10 had temperature and humidity set by the nurses while the next 10 had incubator settings determined by the program. Nurses could alter the parameters if the babies were too hot or cold. Incubator temperature and humidity data along with central and peripheral temperatures from the babies were collected autonomicallly onto a cotside computer system.

Results: There were no differences between the groups in mean central temperatures or the periods of time the babies were either too hot (central temperature T(c)>37.5) or too cold (T(c)<36.5). In the control group, the nurses often altered incubator temperature because of changes in the infant's temperature on the monitors. On each day of the study, the nurses deviated from the HeatBalance recommendations between 11% and 22% of the time.

Conclusions: The HeatBalance program and the nurses achieved similar results in temperature stability for these immature infants. Whichever method was used to determine the initial incubator settings, this study highlighted the importance of continuous monitoring of central and peripheral temperatures in these infants.