Thermal Blanket to Improve Thermoregulation in Preterm Infants: A Randomized Controlled Trial

Abstract

Objective: To determine the effectiveness of temperature-controlled thermal blanket as additional thermoprotection.

Design: Randomized controlled prospective study.

Setting: Single-center tertiary neonatal unit.

Patients: Inborn very low-birth-weight (< 1,500 g) infants.

Interventions: Infants were prospectively assigned to thermal blanket group or control at 1:1 ratio. Additional to radiant warmers, a prewarmed blanket of Blanketrol II (Cincinnati Sub-Zero Products, Cincinnati, OH) was applied as mattress for thermal blanket group. The outcomes included temperature and blood pressure changes. We defined hypothermia as temperature less than 36°C and hypotension as mean arterial pressure less than index infant's gestational age in weeks.

Measurements and main result: Total 80 very low-birth-weight infants were allocated, and there was no between-group demographic dissimilarity. At 30th minute, fewer infants in thermal blanket group were hypothermic (43% vs 68%; p = 0.025). These infants had significantly lower prevalence of hypotension, which associated with less dopamine use in the first 6 hours of life (25% vs 50%; p = 0.016). There was no hyperthermia more than 37.5°C episode.

Conclusions: By using thermal blanket to provide additional thermal protection for very low-birth-weight infants, the degree of hypothermia was improved, which related to fewer hypotensive cases and less dopamine usage.