Premature Infant/ Thermoregulation Flashcards
Problems in the respiratory system
Decreased lung maturity and surfactant production structural immaturity Decreased cough reflex- risk aspiration ARDs Apnoea of prematurity
Problems in the Gastrointestinal/urinary system
Regurgitation- relaxation of cardiac sphincter
Reduced swallow reflex
Decreased intestinal enzymes- decreased food tolerance
Immature liver- risk for hypoglycaemia, jaundice
Immature kidneys- inability to concentrate urine, risk dehydration
Problems with thermoregulation
Increased body area to weight
Underdeveloped sweat glands and shivering reflex
Decreased brown fat
Decreased tone and muscular activity
Why is preterm infant higher risk for infection?
Underdeveloped immune response
Invasive procedures
Exposure to hospital pathogens
What opthalmic problems may the preterm infant be at risk of?
Retinopathy of prematurity
- Blood vessels in the eye grow abnormally and randomly. These vessels can leak or bleed causing scarring to the retina
What are the different ways of heat loss in the infant?
- Convection: heat loss through air current
- Conduction: heat loss through a cold surface
- Evaporation: heat loss from wet skin
- Radiation: loss of heat to cold structures/items
Prevention of convection?
Position baby away from aicon/fans
Prevention of conduction?
Place towel on scale before weighing baby, warm equipment before use, heat up resus trolley before use
Prevention of evaporation?
Dry infant effectively with warm towels
Prevention of radiation?
Move from cold windows or instruments, use incubator
What are some mechanisms to conserve heat?
Peripheral vasoconstriction, increased heat production- increase muscle activity, non-shivering thermogenesis
What is non-shivering thermogenesis?
This is a mechanism by which the neonate can produce heat without shivering. This occurs due to increase the cellular metabolic rate in skeletal muscle or in brown fat- uncoupling of protons moving down mitochondrial gradient from synthesis of ATP allows energy to be dissipated as heat
What is a thermoneutral environment?
Ambient temperature at which 02 consumption and energy expenditure are at minimum to maintain vital activities
What are the effects of cold stress in the infant?
Increase glucose and 02 requirement
Peripheral shunting to central organs
Metabolic acidosis
Intraventricular haemorrhage
Nursing cares to prevent heat loss?
Pre-warmed incubator
Keep baby 36.5-37
Humidity in infants <1500g
Skin to skin
