Effect of the use of a polyethylene wrap on the morbidity and mortality of very low birth weight infants in Alexandria University Children's Hospital

Abstract

Background: Thermal management of the very low birth weight (VLBW) infant (<1500 g) is a cornerstone of neonatology because thermal stress is an important determinant of survival. The present study aimed to evaluate the safety, efficacy, and feasibility of applying polyethylene occlusive skin wrapping to prevent hypothermia during resuscitation at birth in VLBW neonates.

Participants and methods: Using a quasi experimental nonrandomized study design, 50 preterm VLBW infants were wrapped immediately after birth by low-density polyethylene transparent plastic wraps and another 50 infants were subjected to ordinary resuscitation guidelines, and both were admitted to the newborn intensive care unit (NICU). Axillary temperatures were measured for both groups in the observational room, on NICU admission, and after 1 and 2 h.

Results: On admission to the NICU and after 1 and 2 h, the wrap group had significantly higher axillary temperatures than the other group (mean±SD were 36.3±0.51°C, 36.9±0.36°C, 37.07±0.18°C and the P values were 0.0001, 0.0001, and 0.001, respectively). There was a significant increase in the duration of oxygen therapy, requirements for assisted mechanical ventilation, incidence of early hypoglycemia, and higher mortality rate among the infants in the nonwrap group.

Conclusion: Polyethylene transparent plastic wraps effectively help to prevent hypothermia in VLBW infants admitted to the NICU. It is recommended to include this safe, inexpensive tool for the management of VLBW and extremely low birth weight infants especially in the developing countries.