Application of plastic wrap to improve temperatures in infants born less than 30 weeks gestation: A randomized controlled trial

Abstract

Purpose: The primary aim of the study was to evaluate whether the application of a plastic wrap immediately after birth is more effective than the standard care of temperature management for improving admission temperatures to the neonatal intensive care unit (NICU) in infants, 30 weeks gestation. Design: A randomized controlled trial was conducted. Infants in the intervention group were transferred to a prewarmed radiant heater immediately after birth and encased in NeoWrap from the neck down without being dried. The infant's head was dried with a prewarmed towel and a hat added. The control group received usual care for the unit; the infant was transferred to the prewarmed radiant warmer and dried, and warm towels and a hat are then applied. Sample: A total of 92 infants were analyzed: 49 in the control group and 43 in the intervention group; 48 (52.2 percent) were <27 weeks gestation, and 44 (47.8 percent) were <30 weeks gestation. The infants' temperatures were assessed for two hours following admission. Main Outcome Variable: The application of a plastic wrap and hat significantly increased NICU admission temperature in infants <30 weeks gestation. Results: Of the 92 infants, 43 (51.2 percent <27 weeks and 48.8 percent <30 weeks) were randomized to the experimental group and 49 (53.1 percent <27 weeks and 46.9 percent <30 weeks) to the control group. The mean first temperature was 36.15°C (SD = 5 0.85) for intervention and 35.81°C (SD = 5 0.91) for control infants (p5.074); whereas the respective admission temperatures were 36.26°C (SD = 5 0.68; n 5 42) and 35.79°C (SD = 5 0.77; n 5 44; p5.004). The mean temperature of the infants rose steadily from the time of birth to two hours follow-up in both the intervention (36.15°-37.03°C; SD = 5 0.49; n 5 40) and control groups (35.81°-36.75°C; SD = 5 0.70; n 5 47; p