Background: In many hospitals, transferof sick newborns from delivery room to NICU requires transfer
from the overhead warmer in the delivery room to the NICU by using a transport incubator
resulting in significant thermal stress, respiratory and hemodynamic instability.
We have developed a novel device to improve thermoneutral environment during this
early critical phase, which incorporates an overhead warmer and an incubator. The
purpose of this study was to compare the impact of using this device on admission
thermal stability.
Methods: 35 newborns were included in this cohort study. Fourteen infants with birth weights
of less then 1500g (n=21, range 540–1490g) and 11 sick children (CDH, n=14, CCAM n=2)
were transported in a Giraffe OmniBed from delivery room to the NICU. This hybrid
device was upgraded for this study with a cardiorespiratory monitor (GE Dash 4000),
a mechanical ventilator (Stephan), a suction source and gas supply. After delivery,
the babies were resuscitated in the labor and delivery area using the device in the
open bed, radiant warmer mode and then transported in closed bed, incubator mode to
the NICU (a distance of approximately 500 m).
Results: All initial resuscitation procedures including catheterization of the umbilical vessels,
were performed without any problems using the overhead mode. The average rectal temperature
measured immediately upon admission to the NICU for all babies was 36,7°C (median,
range 36,2–37,2°C). The average temperature was 0,4°C higher than in the historical
control group of 30 babies transported with a conventional transport incubator (p=0,045).
Discussion: Using this novel hybrid device for resuscitation in the delivery room and for transfer
to the NICU resulted in improved thermal stability. This device allows to initiate
and maintain mechanical ventilation without any disruption and may help to maintain
continuing life support to result in admission of more stable infants to the NICU.
