Heat loss prevention in very preterm infants in delivery rooms: a prospective, randomized, controlled trial of polyethylene caps

Objective: To evaluate in preterm infants whether polyethylene caps prevent heat loss after delivery better than polyethylene occlusive wrapping and conventional drying.

Study design: This was a prospective, randomized, controlled trial of infants <29 weeks' gestation including 3 study groups: (1) experimental group in which the heads of patients were covered with a polyethylene cap; (2) polyethylene occlusive skin wrap group; and (3) control group in which infants were dried. Axillary temperatures were compared at the time of admission to the neonatal intensive care unit (NICU) immediately after cap and wrap removal and 1 hour later.

Results: The 96 infants randomly assigned (32 covered with caps, 32 wrapped, 32 control) completed the study. Mean axillary temperature on NICU admission was similar in the cap group (36.1 degrees C +/- 0.8 degrees C) and wrap group (35.8 degrees C +/- 0.9 degrees C), and temperatures on admission to the NICU were significantly higher than in the control group (35.3 degrees C +/- 0.8 degrees C; P < .01). Infants covered with polyethylene caps (43%) and placed in polyethylene bags (62%) were less likely to have a temperature <36.4 degrees C on admission to the NICU than control infants (90%). In the cap group, temperature 1 hour after admission was significantly higher than in the control group.

Conclusions: For very preterm infants, polyethylene caps are comparable with polyethylene occlusive skin wrapping to prevent heat loss after delivery. Both these methods are more effective than conventional treatment.