고위험신생아의 저체온증 현황 및 관련요인
Hypothermia and Related Factors in High-Risk Infants
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. Methods: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. Results: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. Conclusion: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.
Abstract
Purpose: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. Methods: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. Results: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. Conclusion: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.
참고문헌 (30)
- The Korean Society of Neonatology, "Manual of neonatal care", The Korean Society of Neonatology, 58~59 (2014)
- "Thermal protection of the newborn: A practical guide" (1997)[URL]
- Karsten Lunze, "The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival", BMC Medicine, 11(24), pp.1~11 (2013), Springer Nature[DOI]
- John l. Takayama, "Body Temperature of Newborns: What is Normal?", Clinical Pediatrics, 39(9), pp.503~510 (2016), SAGE Publications[DOI]
- A. R. Laptook, "Admission Temperature of Low Birth Weight Infants: Predictors and Associated Morbidities", PEDIATRICS, 119(3), pp.e643~e649 (2007), American Academy of Pediatrics (AAP)[DOI]
- Emma M McCall, "Interventions to prevent hypothermia at birth in preterm and", or low birthweight infants, 2010, pp.17(3), CD004210~[DOI]
- Robin L. Bissinger, "Thermoregulation in Very Low-Birth-Weight Infants During the Golden Hour", Advances in Neonatal Care, 10(5), pp.230~238 (2010), Ovid Technologies (Wolters Kluwer Health)[DOI]
- S S Miller, "Hypothermia in very low birth weight infants: distribution, risk factors and outcomes", Journal of Perinatology, 31(S1), pp.S49~S56 (2011), Springer Nature[DOI]
- Robin Knobel, "Thermoregulation and Heat Loss Prevention After Birth and During Neonatal Intensive‐Care Unit Stabilization of Extremely Low‐Birthweight Infants", Journal of Obstetric, Gynecologic & Neonatal Nursing, 36(3), pp.280~287 (2007), Elsevier BV[DOI]
- Paik SN, "The influence of thermal head and feet support on early stage weight gain in premature neonates", Korean Journal of Child Health Nursing, 6(3), pp.397~410 (2000)
- Jin Hee Jang, "The Association between Admission Hypothermia and Neonatal Outcomes in Very Low Birth Weight Infants", Neonatal medicine, 23(4), pp.183~189 (2016), 대한신생아학회
- 안영미, "고위험신생아의 생후 초기 표피 pH, 온·습도와 산성덮개 형성 요인", Journal of Korean Academy of Nursing, 43(1), pp.30~38 (2013), 한국간호과학회
- 최영륜, "의학강좌", 미숙아 및 저체중 출생아의 관리, 2008, pp.51(8), 745~754[DOI]
- R F Soll, "Heat loss prevention in neonates", Journal of Perinatology, 28(S1), pp.S57~S59 (2008), Springer Nature[DOI]
- Maureen C. Reilly, "Randomized Trial of Occlusive Wrap for Heat Loss Prevention in Preterm Infants", The Journal of Pediatrics, 166(2), pp.262~268 (2015), Elsevier BV[DOI]
- 이상미, "입원 신생아에 있어 환경 온·습도에 따른 체온변이", 한국생활환경학회지, 19(6), pp.746~753 (2012), 한국생활환경학회
- Kim HS, "Hypothermia during prehospital transportation of neonates", Journal of the Korean Society of Emergency Medicine, 10(4), pp.680~685 (1999)
- 이상복, "캥거루식 접촉이 신생아 집중치료실 미숙아의 생리적 지수에 미치는 효과", 동서간호학연구지, 18(2), pp.59~65 (2012), 동서간호학연구소
- 김희영, "물주머니를 이용한 가온요법이 고위험신생아의 체온과 산소요구도, 호흡수, 혈당에 미치는 효과", Child Health Nursing Research, 11(4), pp.390~395 (2005), 한국아동간호학회
- MA Marín Gabriel, "Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn", Acta Paediatrica, 99(11), pp.1630~1634 (2010), Wiley-Blackwell[DOI]
- S Chawla, "Safety and efficacy of Trans-warmer mattress for preterm neonates: results of a randomized controlled trial", Journal of Perinatology, 31(12), pp.780~784 (2011), Springer Nature[DOI]
- Maria Fernanda Branco de Almeida, "Hypothermia and Early Neonatal Mortality in Preterm Infants", The Journal of Pediatrics, 164(2), pp.271~275 (2014), Elsevier BV[DOI]
- Tinuade A Ogunlesi, "Point-of-admission hypothermia among high-risk Nigerian newborns", BMC Pediatrics, 8(40), pp.1~5 (2008), Springer Nature[DOI]
- Marco Pezzati, "Changes in Skin Temperature of Hyperbilirubinemic Newborns Under Phototherapy: Conventional Versus Fiberoptic Device", American Journal of Perinatology, 19(8), pp.439~444 (2002), Georg Thieme Verlag KG[DOI]
- LAURA A. STOKOWSKI, "FUNDAMENTALS OF PHOTOTHERAPY FOR NEONATAL JAUNDICE", Advances in Neonatal Care, 6(6), pp.303~312 (2006), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Park JH, "A comparative study on the changing pattern of temperature of newborn infants depending on the use of radiant warmers", master, pp.2005
- DR Bhatt, "Transitional hypothermia in preterm newborns", Advances in Neonatal Care, 10(Suppl 5), pp.S15~S17 (2010), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Brian M. Casey, "The Continuing Value of the Apgar Score for the Assessment of Newborn Infants", New England Journal of Medicine, 344(7), pp.467~471 (2001), New England Journal of Medicine (NEJM[DOI]
- Adam Rosenberg, "The IUGR Newborn", Seminars in Perinatology, 32(3), pp.219~224 (2008), Elsevier BV[DOI]
- Zubair DS, "Comparison of outcome in IUGR and normal pregnancies-A retrospective study", International Journal of Medical Research and Review, 4(4), pp.646~649 (2016)[DOI]
