Placing VLBW infants in polyethylene bags lowers hypothermia risk during transport
Using polyethylene plastic bags when transporting very low birthweight (VLBW) infants from one hospital to another appears to effectively reduce the occurrence of hypothermia, especially moderate hypothermia, a study reports.
A total of 108 infants with birth weight <1,500 g were randomly assigned to the standard thermoregulation protocol (swaddling in a blanket in the transport incubator and a hat to cover the head; n=54) or the intervention protocol (standard thermoregulation protocol with placement of the torso and lower extremities inside polyethylene bags; n=54).
Baseline characteristics were similar between the two groups. However, the plastic bag intervention proved superior to the standard intervention in terms of primary outcome measures. Specifically, the rate of moderate hypothermia in the plastic bag group was lower (3.7 percent vs 27.8 percent), and ancillary temperatures after transport were higher in infants whose extremities were placed inside plastic bags (36.4 vs 35.9 °C; p=0.001).
Compared with standard thermoregulation, use of polyethylene plastic bags reduced the risk of hypothermia by about 90 percent (risk ratio, 0.10; 95 percent CI, 0.02–0.46; p<0.001).
However, researchers also acknowledged that if the transport incubator temperature was servo-controlled and the temperature of the incubator could be adjusted according to the infants’ skin temperature, a plastic bag might not be beneficial.
Furthermore, despite the relative success of wrapping infants in polyethylene plastic bags during transport, 61.1 percent of infants in the study still developed mild hypothermia upon admission to a neonatal intensive care unit (NICU).
One possible means to reduce the progression of hypothermia is to place VLBW newborns in a plastic bag from the moment they are born up until they are transported to the NICU, researchers said. Moreover, staff training and awareness must be improved in all areas of perinatal care.
Additional studies investigating the combination of plastic bags used in the delivery room and during transport are needed.