Download Neonatal hypothermia

Neonatal hypothermia
cold stress
Cold injury
Definition& pathophsiology
• Is a core temperature <35-35.5C. Rectal temp.
• May be mild 35-32 C or severe<32C.
• Neonates are prone to hypothermia because of large surface area relative
to the body size and is more risk in premature and low birth wt neonates.
Loss of heat may be by radiation to cooler surrounding objects or by
evaporation of water from skin, or by conduction when skin come in touch
with cooler objects or by convection when cool air take the heat from the
skin .
• response to heat loss is by vasoconstriction of skin and other tissues and
by nonshivering thermogenesis by using the brown fat to generate calorie
and heat.
• Brown fat is present arround the kidneys ,adrenals and neck, between the
scapula and in the mediastinum. when it used no replacement for it so it
will finish when used and it is present till 6 month.it is mainly deposited
during the 3rd trimester.so premature are with less brown fat.
• Hypothermia leads to hypoglycemia, metabolic acidosis, loss of glycogen.
aetiology
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Delay wrapping in cold environment at birth.
prolonged resuscitation in cold delivery room.
exposed body to cold bed or room after birth.
Sepsis
Intracranial hemorrhage
Clinical features
cold injury
• Hypothermia cause depression in all activities
of body organs leading cold skin, to poor
feeding, lethargy, poor cry, bradycardia,
arrhythmia, respiratory distress due to
vasoconstriction and low surfactant
formation, cyanosis, skin mottling, prone to
sepsis, even coma and death.
Treatment and prevention
• In the hospital ; gradual Rewarming by putting under
warmer or in incubator with gradual increase in body
temp. goes with the gradual increase in incubator
temp.
• Treat underlying causes like sepsis or intracranial
bleeding .
• prevention is by;
Rapid Wrapping the baby to remove the moist from skin
at birth to let the skin dry ,and resuscitation in trolley
under warmer to prevent loss of heat at birth.
At home in cold season the infant should be wrapped and
not exposed to cold.