Increasing ambient operating theatre temperature and wrapping in polyethylene improves admission temperature in premature infants

Aim: To improve admission temperatures of preterm infants ≤31 weeks gestation by increasing the ambient temperature in the operating theatre and wrapping in polyethylene wrap at caesarean section. Methods: A review of admission temperature of infants with gestational age ≤31 weeks from January 2000 to July 2002 was performed. Between October 2002 and 2003 the ambient operating theatre temperature was increased to 26-28°C for deliveries ≤27 weeks gestation and to 25°C for deliveries ≥28 weeks gestation. From September 2004 to December 2005 the ambient theatre temperature was increased along with wrapping infants in polyethylene. A clinical audit cycle review of admission temperatures and early morbidity and mortality was undertaken. Results: 156 premature infants were included, 42 <28 weeks and 114 28-31 weeks gestation. The mean admission temperature in <28 weeks infants prior to intervention was 35.3°C, after increasing ambient theatre temperature 35.9°C, and after increasing ambient temperature and using polyethylene wrap 37.0°C (P < 0.0001). For infants 28-31 weeks the mean admission temperatures in the three epochs were 36.3°C, 36.5°C and 36.6°C, respectively (P = 0.002). There was no statistically significant difference in: total days of ventilation or oxygen, definite necrotising enterocolitis, intraventricular haemorrhage grade 3 or 4 or survival. Conclusions: Increasing the ambient temperature in the operating theatre and wrapping premature infants in polyethylene wrap improves admission temperature. Further studies are required to determine whether these interventions are associated with improved outcome in the premature neonate.