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Hypothermia

  • A. Sahib El-Radhi
Chapter

Abstract

Hypothermia is defined as a core body temperature (pulmonary, oesophageal, rectal, tympanic) of less than 35 °C, resulting from increased heat loss or decreased heat production. This temperature is more than two standard deviations below the mean core temperature. In paediatric practice, most cases of hypothermia occur during the neonatal period.

The World Health Organization (WHO) defines neonatal hypothermia as a body temperature below 36.5 °C (97.7 °F) and classifies it as mild (cold stress), 36.0–36.5 °C; moderate, 32–36 °C; and severe, below 32 °C.

Neonatal hypothermia is common in infants born in hospitals (prevalence range: 32–85%) and at homes (prevalence range: 11–92%). Neonatal hypothermia is a major cause of mortality globally, even in tropical countries and warm climates, mostly occurring in winter months. The number of neonatal deaths (less than 28 days of age) was estimated to be 3.1–3.6 million in 2009, being 4.6 million deaths in 1990. There is no evidence that hypothermia has any beneficial effect immediately after birth or at any time later.

Hypothermia can be prevented by ensuring that the delivery room is warm: 25–28 °C. Drying and wrapping the baby should be done immediately after birth (before the cord is cut) using a warm blanket or synthetic insulating material, such as an aluminized polyester sheath. Simple drying and wrapping the baby reduce the postdelivery heat loss by more than 50%. Bathing and weighing should be postponed, no water bottles or hot stones.

The baby should be in direct skin-to-skin contact with the mother and covering the baby and mother together. This is particularly important in developing countries where supervision by nursing staff and temperature in the delivery room are often inadequate. The mother and baby should be kept together. Putting a warm cap on the baby’s head, as much as 25% of heat loss occurs from uncovered head.

Keywords

Neonatal hypothermia Cold injury Accidental hypothermia Drowning Management hypothermia Therapeutic use 

References

Neonatal Hypothermia

  1. 1.
    whqlibdoc.who.int/hq/1997_msm_97.2.pdf.
  2. 2.
    Lunze K, Bloom D, Jamison DT, et al. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med. 2013;11:24.CrossRefGoogle Scholar
  3. 3.
    Black RE, Cousens S, Johnson HL, et al. Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–87.CrossRefGoogle Scholar
  4. 4.
    El-Radhi AS, Jawad MH, Mansor N, et al. Sepsis and hypothermia in the newborn infant: value of gastric aspirate examination. J Pediatr. 1983;103:300–2.CrossRefGoogle Scholar
  5. 5.
    El-Radhi AS, Jawad MH, Mansor N, et al. Infection in neonatal hypothermia. Arch Dis Child. 1983;58:143–5.CrossRefGoogle Scholar
  6. 6.
    Mann TP, Elliot RI. Neonatal cold injury due to accidental exposure to cold. Lancet. 1957;1:229–33.CrossRefGoogle Scholar

Hypothermia in Older Children

  1. 7.
    Peden M, Oxegbite K, Ozanne-Smith J, et al. World report on child injury prevention. Geneva: World Heath Organization; 2008.Google Scholar
  2. 8.
    Leading article: immersion and drowning in children. Br Med J. 1977;3:146–7.Google Scholar
  3. 9.
    Smith ML, Auer RN, Siesjo BK. The density and distribution of ischaemic brain injury in the rat following 2-10 minutes of forebrain ischaemia. Acta Neuropathol. 1984;64(4):319–32.CrossRefGoogle Scholar
  4. 10.
    Dorothy NE, Fung P, Lefkowitz M, et al. Hypothermia and sepsis (letter). Ann Intern Med. 1985;103:308.Google Scholar
  5. 11.
    Lewin S, Brettman LR, Holzman RS. Infections in hypothermic patients. Arch Intern Med. 1981;141:920–5.CrossRefGoogle Scholar
  6. 12.
    Sadikali F, Owor R. Hypothermia in the tropics: a review of 24 cases. Trop Geogr Med. 1974;26:265–70.PubMedGoogle Scholar

Cinical Use of Hypothermia

  1. 13.
    Gunn AJ, Laptook AR, Robertson NJ, et al. Therapeutic hypothermia translates from ancient history in to practice. Pediatr Res. 2017;81(1–2):202–9.CrossRefGoogle Scholar
  2. 14.
    Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when?, where?, why? Lancet. 2005;365:891–900.CrossRefGoogle Scholar
  3. 15.
    Levene MI, Evans DJ, Mason S, et al. An international network for evaluating neuroprotective therapy after severe birth asphyxia. Semin Perinatol. 1999;23:226–33.CrossRefGoogle Scholar
  4. 16.
    Jacobs SE, Berg M, Hunt R, et al. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013;31(1):CD003311.Google Scholar
  5. 17.
    Zingg W. Historical use of hypothermia for cancer. Can J Surg. 1983;26:97–8.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • A. Sahib El-Radhi
    • 1
  1. 1.Chelsfield Park HospitalOrpingtonUK

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