Thermal support for the very-low-birth-weight infant: Role of supplemental conductive heat

Heated water pads were placed underneath very-low-birth-weight preterm infants receiving care under overhead radiant warmers with plastic heat shields to evaluate the effects on their thermal environments. The electrical input (watts) to the overhead warmer was monitored and temperatures at various locations in the environment and on the infants were recorded. The electrical input to the radiant warmers decreased significantly (P=0.0015) with the introduction of the heated water pads. Several of the temperatures recorded during the study also showed significant changes, including increased abdominal skin temperatures in these prone infants (P=0.007) and decreased back-to-abdomen skin temperature gradients (P=0.007). Less marked changes included higher mattress or pad temperatures (P=0.019), lower ambient air temperatures within the plastic heat shields (P=0.022), and increased infant foot temperatures (P=0.036). We believe that conduction has a significant influence on the thermal environment of the VLBW infant cared for under an overhead radiant warmer and that the use of a heated water pad can markedly alter heat transfer. The impact of conduction appears to have been previously underestimated.