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Masalah Suhu
. Normal : 36,5 - 37,5oC
. Pengukuran di akila selama 3'
HnPOTEB,e{ne . Hindari pengukuran di anus
. 4 cara kehilangan panas : konduki, evaporasi,
konveki, dan radiasi
. Hipotermi adalah pembunuh utama
trNYY.&NT8I
pada neonatus

Hypthermia Infunt Bod,y Temperature


l$s3t 'fl,clrrerabl,B ' Classification of hypothermia' based on core temperature
:: Premature / low birth weight Mild -+ 36.4 to 36"C (97.6 to 96.8qF)

:r, Small for gestatonal age Moderate + 35.9 to 3?C {96.6 to 89.6oF)
Serere -+ less than 3?C
i. lnfunt$ underg.|ing prolonged
resuscitation
Axi,lar temperature goal ) 35,5-37,SoC

:: lniants who become actrtely ill -+


hypothermia ofien accompanies
sepsis ard other illnesses
..: Oth€r -+ open abdominal / spinal
debcts :ifodd il6k$ Orsieiar f l!3,9?i
IrH,e,pltLrD$oJilp t*\14tu1t. s F @{rnl
;: !;;s

Normal Rxponse to GOLB STHE$S Normal Response [o Gl]l-g 5TB[5S


Vasoconstriction in arms and legs &r*Ylr3 fat
Blood stays in core of body lnadequate amount prior to late third trimester
Prevents blood ftom Mechanism
reaching skin surbce Generates heat v/hen "buned" or metabolized
where heat loss occurs
t \Aiarms blood circulating past areas whh brown kt
Prolonged vasocon$riction may impair perfusion
and tissue oxygenation
-r mediaslinum, scapulae, axillae and kidneys
lVhintairs body temperature after birth
':' t Movement and ffexion of extremities
: lfhypoxic-+cannot
Generates warmth in muscles quil iat
metabolize brown i
Decreases surface area for -r\/
heat loss :), "j
'
,
';;.;;s*
Brown fat metabolisrn
Y *.. - r
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Orygen C.onsumption and Tanperaturc Heat Lass


. Mechanisrns of heat loss

Conduc,tion L

Convection
Eraporation

grel Radiation

,'it
: ..
. t2 'J1 30 29/
]lormal
{ Body T?mperaturE i"Ci 1,
t
tempeEtute
*=*+ f

n*trr_S4@@_ Heat Loss by eductiwt


Heat transier between two solld oblects :
iPre-warm objects before contacl with
F'
Warm Ploced on
i,infant -+ bed, hands, stethoscope,
x-ray plates, blenkets; apply hat
..' tte'+,'
fuby "."re; unheated surfae

t,
Z-' ;...-----; 1,,...-
..
\/\*j --r'*'
((r '-l'- ''-- ^-'t ' ,-, ri
-
-
Bafu loses
heat to surface
f,
,d..,**,**'ry*.*"!::;=S &.*-.
.

FI
- t*
'Cover scale with warm blankat ard re-zero before
weighing
:' t Never microwane blankets or place on top of radiant
warmer unit to heat -+ use blanket warmer
My tefiperaturc drops

ffi ffi
Hwt Loss by Caadluc**wr HeatLoss by Cordum&oa
: Uncontrolled heat sources -+ high risk of burns and
lf premature, place ctnmical ialrogenic hypefthermia
thermal matress under baby -+ X Hotwaterbottles
cover first with thin oloth or blanket ::;,t €! x Hot water filled gloves

,!a

/-
#
ffi x Mi$owave heated blankets

,i.:
I

-t
?J

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Heat loss iaster if room Less than 1.5 kg infant


temperature cool -+ cover ftom neck to
t Room temperature tuetwith plastic
obshuct ainrayl

Heat Los by Csf,nffififua


,!:{e""_rylLlglnts_i

J-)

Provide wann envionment in Less than 1.5 lqg infant


delivery room and nursery -+ -+ cover with plastic
especially for premature

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Heat Loss by ftqpotirtirn Hmf Loss by eadid&rn


--r)
+ i Heat trans$er between solkl surtaces
5 i
_ __!gI !*t1{n qsjq:l-,r i

Move away from windows and outskle walls

-] ' Use double walled irpubator


[D"rotbq$r"inEE"if
L_lryqhermtcor,nstablej

-====1:-

Hmt C*in by&rdliation Hwt (*kby*odiwtion


: Risk of overheating --r warmer on manual conhol i

l Risk of overheating + protect from direct sunlight or loose temperature probe i

t
\
'd
&*

Heat C,ain byRad$miom Derrim mtal Efr:trts of PllT HE[tlA


il_T
$reMile gsffific
: lf no warmel or incubator available I
,-, Heat loss very rapid -+ fastet than ability to canserue
cautrously use heat lamp _) body heat
'
' Minimal to no bmwn fat
'.. No insdating tat
. Poor ability to vasoclnstrict first
bw days of lifa -+ blood reactres
skin suriace where heat loss t
occurs -\
Weak muscle tone, poor flexion -+
tbody surtace area ior heat loss '
*'*-
Limitedtorroglycogenslores-+
Hffi;d;sf;#ffi"
:: -'
.._o.s.
.-,r.
-l
d

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Upaya Menurunkan Risiko Hipotermi

. Suhu optimal untuk ruangan bersalinlOK dan ruang


perawatan
. Suhu ruangan bayi ideal 24-26 C
. Alas ticiur dan handuk pembungkus hangat
. Dilapisi plastik bersih
. Inkubator transpor hangat
. Saat melakukan tindakan, pastikan bayi hangat
. Pintu inkubator jangan sering dibuka
. Bila sudah stabil ) metode kanguru