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Protecting the Most Vulnerable – Keeping the Baby Warm

ge_quality_final_notypeBirth is an exciting time for most families, but it can be a frightening experience. Every year, an estimated 15 million babies are born preterm, and this number is rising. Some weigh as little as a pound and yet face oversized challenges. When babies are born too soon, premature infants’ temperature can fall lower due to the thin, poorly developed skin and a relatively large surface area in relation to body weight. 50% of babies have low neonatal intensive care unit (NICU) admission temperatures 1,2,3.

“Sometimes, the basic vital things we can measure on the infants are the most crucial for a good outcome” explained Dr Morten Breindahl, President of the European Society for Neonatology (ESN). Indeed, maintaining thermoregulation from birth is a vital priority and an important part of newborn stabilization, resuscitation and transition period, as every 1°C decrease in NICU admission temp contributes to 28% increase in mortality1,2,3,4 and 11% increase in sepsis4.

In the past, the NICU environment often presented the tiny newborn with inappropriate stimuli from light, sound, touch and procedures as well as being a stressful and worrying place for parents.  The modern neonatal unit and delivery suite employs increasing technology designed to keep an infant’s condition optimal and stable with minimal disturbance. Technology such as the GE Giraffe OmniBed has become an inevitable and necessary feature of intensive care areas. As for a premature infant, the first few months of a giraffe’s life are the most vulnerable. The giraffe mothers are extremely protective, just as GE’s “Giraffe”: it protects the new born from external factors and provides all the comfort for a safe tiny baby’s new home – stable thermal support, a comfortable and quiet atmosphere, the right design to encourage kangaroo care and parental bonding.

 “Today we are able to treat and have very immature infants survive. We were not so good at this only 10 to 20 years ago. However, we still have significant challenges in maintaining and securing a stable environment and condition, for example during transport of these vulnerable infants between hospitals and even from one department to another for a specific diagnostic procedure or treatment,” says Dr Breindahl.

OMNIBED_-_NURSE_HANDLING_BABY

When infants are transferred from one bed surface to another, body temperature and physiologic stability can be compromised. Traditional intra-hospital transport requires the movement of infants from multiple microenvironments, which may increase the likelihood of complications impacting continuity of care and thermoregulation2: 27.3% of intra-hospital transports experience clinical complications5.

Listening to the clinicians needs, GE’s One baby. One bed workflow is built on the simple idea that infants should remain in the same Giraffe bed from admission to discharge avoiding bed transfers, reducing potential for clinical problems associated with interrupted thermal regulation and negative patient touches, handling and movement, and consequently any misadventures that could occur during neonatal transportation. A big step forward.

“Neonatal transportation is a high-risk field of medicine that has seen an immense development over the years and we have to keep on track and be able to cooperate with one another. The way we are dealing with neonatal transportation is really different from one country to another and even within one country. There is a great potential to standardize these procedures, agreeing on specific key performance indicators so that we can leverage the treatment and the stabilization methods that we provide to these very instable and sick infants.” Dr. Breindahl says, and concludes: “Temperature control is a good example of a well known challenge in the preterm infant. Despite years´ of research, gaps in our knowledge remain, but also available research opportunities. However, proven thermoregulatory methods – including basic such as the use of a well-designed plastic covering as well as high-end incubator products – should be given much more emphasis and be practiced and implemented meticulously wherever and whenever birth takes place6”.

1 – Miller SS, Gould JB, and Lee HC. Hypothermia in very low birthweight infant: Incidence and risk factors. Pediatric Academic Society Meeting, 5/6/2007, E-PAS2007:616280.31.

2 – Bhatt DH, Carlos CG, Parikh AN, White R, Seri I, and Ramanathan R. Prevalence of transitional hypothermia in newborn infants on admission to newborn intensive care units. Pediatric Academic Society Meeting, 5/7/2007, E-PAS2007:617933.23.

3 – Barber N, DeCristofaro JD, and Chen J. Hypothermia and re-warming in extremely low birthweight infants and subsequent clinical consequences. Pediatric Academic Society Meeting, May 2006, EPAS2006:59:365.

4 – Laptook AR, Salhab W, Bhaskar B and Neonatal Research Network. Admission temperature of low birthweight infants: Predictors and associated morbidities. Pediatrics 2007; 119:e643-e649.

5 – Viera ALP, N. do Santos AM, Okayama MK, Miyoshi MH, de Almeida MFB and Guinsburg R. Factors associated with clinical complications during intra-hospital transports in a neonatal unit in Brazil. Journal of Tropical Pediatrics, 12/2010

5 – Chitty et al. Semin Fetal Neonatal Med 2013, Dec;18(6):362-8

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