Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

Luca Filippi, Serena Catarzi, Letizia Padrini, Patrizio Fiorini, Giancarlo La Marca, Renzo Guerrini, Gian Paolo Donzelli

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To present the results of a strategy designed to reduce the incidence of skin complications in newborns with hypoxicischemic encephalopathy treated with moderate whole-body hypothermia. Design: Retrospective study. Setting: Neonatal Intensive Care Unit (NICU). Patients: Thirty-nine neonates cooled in the considered period. Intervention: Starting from January 2008, for neonates treated with moderate whole-body hypothermia (33.5 °C), the cooling system was set in "automatic servo-controlled mode (ACM)", where the temperature of the circulating water could vary between 4 °C and 42 °C. Starting from January 2009, cooling blankets were used in another type of automatic mode, the "gradient variable mode (GVM)", where the circulating water was maintained at a specific pre-set gradient towards the patient's body temperature, and a specific nursing protocol (NP) was adopted. Measurements and main results: Two of the eleven newborns treated with the "ACM" exhibited skin complications compatible with subcutaneous fat necrosis (SFN). None of the twenty-eight newborns treated with the "GVM" exhibited skin complications. A comparison of the biochemical and hematological data between these two groups revealed that newborns treated after the adopting of a NP and the "GVM" showed lower serum protein C and calcium levels, and higher platelet levels. Conclusions: Our data suggest that newborns undergoing therapeutic cooling may benefit from a specific NP and correct cooling unit setting. Should further studies confirm our data, this nursing approach could be easily adopted.

Original languageEnglish
Pages (from-to)2115-2121
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 2012

Keywords

  • Asphyxia
  • Hypothermia
  • Hypoxic-ischemic encephalopathy
  • Newborn
  • Subcutaneous fat necrosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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