Randomized Trial of Occlusive

Wrap for Heat Loss Prevention in

L/O/G/O
Preterm Infants

Randomized Trial of Occlusive Wrap for Heat Loss

Prevention in Preterm Infants

Disusun Oleh:

Fitrianindita
Ridwan Taufik
Pembimbing:

dr. Suherjati Setiyadi, Sp. A

BAGIAN/SMF ILMU KESEHATAN ANAK
FAKULTAS KEDOKTERAN UNIVERSITAS MALAHAYATI
RSUD CIAMIS JAWA BARAT
TAHUN 2015

Introduction
Hypothermia has been recognized
as an independent risk factor for death
in newborn infants.

Immature

Very preterm infants are

particularly vulnerable to heat
loss because of:

Keratin deficient
skin without
subcutaneous
fat
Poor
vasomotor
control
increased
surface area
to body
weight ratio

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Cramer et al

The applicationEvaluated
of occlusive
wrap immediately
after
birth can
3 small,randomized
controlled
trials
reduce immediate
heat loss.
and 5postnatal
trials using evaporative
historical controls
that studied the use of occlusive wrap immediately
after birth in infants born
at less than
weeks gestation.
The33
conclution:
The
systematic reduced
review did
show a of
significant
difference
Significantly
thenot
incidence
hypothermia
in mortality between wrapped and unwrapped infants.

to determine whether
the use of wrapping immediately
after delivery would result in a difference in mortality

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Methods

Hypothesized:
Polyethylene occlusive wrap applied immediately
after delivery to infants born at 24 0/7 to 27 6/ 7
weeks gestation would result in decreased mortality
compared with the conventional method of drying and
thermal management.

Participants:
Randomized Controlled Trial (RCT) at 39 participating
Vermont Oxford Network (VON) centers (enrollment
of 801 infants in each group was planned).
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 Respiratory distress syndrome

Bronchopulmonary dysplasia
Seizures
Patent Ductus Arteriosus (PDA)
Necrotizing enterocolitis,
- All-cause mortality occurring before discharge from the
Gastrointestinal
perforation,
hospital or 6 months corrected age, whichever came
Primary
first. hemorrhage,
Intraventricular
- Trial infants who remained hospitalized at 6 months
Outcome
Cystic periventricular
leukomalacia,
corrected age were coded as being alive.
Pulmonary hemorrhage,
Retinopathy of prematurity,
Sepsis,
Rectal
temperatures were optional
Pneumothorax
- Secondary outcomes included baseline temperature

and only taken when

were not stabilization.
wrapped.
takeninfants
after cardiorespiratory
Axillary temperature
on Apgar
wrapped
taken
over the wrap
- Included
scores,infants
pH, basewas
deficit,
and blood
pressure
and blood
to prevent opening
the wrap
andglucose.
potential cooling of the infant.
Secondary

Outcomes

- The incidence of common complications of

prematurity were compared.
- All temperatures were axillary and taken with a
standardized
thermometer
(Medline
Digital
Thermometer, Munde- lein, Illinois).

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Statistical Analyses
Stratum 1: 24 0/7 weeks
to 25 6/7 weeks
Stratum 2: 26 0/7 weeks
to 27 6/ 7 weeks

Results were reported

with OR and their
associated 95% CI.

Secondary outcomes
were compared between
groups using c2 analyses
or t tests

All analyses used SAS

Version 9.2 (SAS Institute,
Cary, North Carolina)

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