Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society

Pierre Tourneux (1, 2) , Gérard Thiriez (3) , Laurent Renesme (4) , Claire Zores , Jacques Sizun (5, 6, 7) , Pierre Kuhn , Aurore Allen , Frédérique Audeoud , Charlotte Bouvard (8) , Anne Brandicourt , Laurence Caeymaex (9, 10) , Marie Agnès Duboz , Anne Evrard (11) , Christine Fichtner , Céline Fischer-Fumeaux , Laurence Girard , Françoise Gonnaud , Petra Hüppi , Nadine Knezovic , Pierre Kuhn (12) , Elisabeth Laprugne-Garcia , Sophie Legouais , Fabienne Mons , Jean‐baptiste Muller , Jean‐charles Picaud , Véronique Pierrat , Patrick Pladys , Audrey Reynaud , Laurent Renesme , Aline Rideau , Jacques Sizun , Gilles Souet , Gérard Thiriez , Marie Touzet , Patrick Truffert , Charlotte Tscherning , Catherine Zaoui , Elodie Zana-Taieb

1 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
2 Soins Intensifs de Néonatologie et Médecine Néonatale / Réanimation et Surveillance Continue de Pédiatrie [CHU Amiens]
3 CHU besancon - Service de Réanimation Pédiatrique, Néonatalogie et Urgences Pédiatriques
4 CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux]
5 Pôle de la Femme, de la Mère et de l’Enfant
6 LNB - Laboratoire de Neurosciences de Brest
7 Equipe SPHERE (CERPOP)
8 Association SOS Prema
9 CHI Créteil
10 UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12
11 Association d'usagers, Collectif interassociatif autour de la naissance (CIANE), Paris, France
12 INCI - Institut des Neurosciences Cellulaires et Intégratives

Aim Thermal instability is harmful on the newborn infant. We sought to draw up practical guidelines on maintaining homeothermy alongside skin-to-skin contact. Methods A systematic analysis of the literature identified relevant studies between 2000 and 2021 in the PubMed database. Selected publications were evaluated, and their level of evidence was graded, in order to underpin the development of clinical guidelines. Results We identified 7 meta-analyses and 64 clinical studies with a focus on newborn infants homeothermy. Skin-to-skin contact is the easiest and most rapidly implementable method to prevent body heat loss. Alongside skin-to-skin contact, monitoring the newborn infant's body temperature with a target of 37.0°C is essential. For newborn infants <32 weeks of gestation, a skullcap and a polyethylene bag should be used in the delivery room or during transport. To limit water loss, inhaled gases humidification and warming is recommended, and preterm infants weighing less than 1600 g should be nursed in a closed, convective incubator. With regard to incubators, there are no clear benefits for single- versus double-wall incubators as well as for air versus skin servo control. Conclusion Alongside skin-to-skin contact, a bundle of practical guidelines could improve the maintenance of homeothermy in the newborn infant.

Domaines: Médecine humaine et pathologie

Pierre Tourneux, Gérard Thiriez, Laurent Renesme, Claire Zores, Jacques Sizun, et al.. Optimising homeothermy in neonates: A systematic review and clinical guidelines from the French Neonatal Society. Acta Paediatrica, 2022, 111 (8), pp.1490-1499. ⟨10.1111/apa.16407⟩. ⟨hal-04012702⟩