Hypothermia Flashcards
Neonatal energy triangle (cold stress)
Cold stress:
- affects oxygenation by increasing pulmonary vascular resistance
- reduces surfactant production
- noradrenaline ->stimulate brown fat to produce heat
- increased metabolic rate (increased metabolic rate increases o2 demand
- tissue hypoxia increases acidosis -> anaerobic metabolism-> increase lac
- increased metabolism -> increased glucose uptake-> depletes glycogen stores -> hypoglycaemia
- peripheral and pulmonary vasoconstriction
- hypoglycaemia reduces surfactant, increases WOB, RD -> hypoxia
Those at risk of poor thermoregulation
- prem
- IUGR
- <12hrs
- resp problems
- Drug exposure
Conduction
One solid object to another
Convection
Body to surrounding area
Evaporation
Heatloss during conversion of liquid to vapour
Radiation
Heat to cooler solid objects not in direct contact
Hypothermia on oxygenation
Increased metabolism to keep warm which increases o2 consumption
Increased noradrenaline-> vasoconstriction
Decreases oxygenation and perfusion
Increase anaerobic metabolism which increases lac and decreases surfactant
Increases hypothermia
Hypothermia and hypoglycaemia
Increased metabolic rate to keep warm
Increased glucose requirement to produce heat
Increased use of glycogen stores
Hypoglycaemia
Hypothermia management
Extra layers
?wet - evaporation or conduction
?draft or by a poor - convection or radiation
?babytherm
Recheck temp in 30 mins if moves to babytherm
Recheck in 45-1hr if added layers
?skin to skin -> increased temp, regulate HR &RR
-observations
-how the baby is feeding
-?lethergic from hypothermia -> hypoglycaemia
-poor feeding -> NGT or IV 10% dex depending on BM
-if hypothermia continues with intervention consider septic screen
- Escalate
- blood gas depending on WOB
- acidotic or high co2 ->increase respiratory support
- inform parents
