Use of a Novel Mathematical Model to Assess the Effectiveness of Skin-to-Skin Care for the Prevention of Hypothermia in Low-Birth-Weight Neonates
Résumé
The effectiveness of skin-to-skin care (SSC) notably depends on the delivery room air temperature (Ta), the thermal insulation provided by the fabrics or clothes covering the mother and the neonate (Icl), and the neonate’s metabolism (M). The objective of the present study was to model the influence of these variables on the effectiveness of SSC for premature newborns. To this end, we used an appropriate thermal mannequin and applied a mathematical model of body heat exchanges. We performed experiments at Ta values (20.9 °C and 25.9 °C) and two Icl values (sheet only and sheet + blanket). At a Ta of 25.9 °C, normothermia was estimated after one hour of SSC with the sheet (Icl = 0.15 m2 °C/W; 36.52 °C) and the sheet + blanket (Icl = 0.21 m2 °C/W; 37.09 °C) but only with the highest value of M (2.70 W/kg). With a Ta of 20.9 °C, moderate hypothermia (requiring monitoring of the neonate’s thermal status) was estimated—except for M = 2.70 W/kg and Icl = 0.21 m2 °C/W. During early SSC, homeothermy can be maintained when Ta is 25 °C (the temperature recommended by the World Health Organization) but only when the neonate’s tissue insulation is high (Icl ≥ 0.15 m2 °C/W) and when the level of metabolic heat production is high.