Heat loss prevention (HELP) in the delivery room: A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants

Objectives To determine if polyethylene occlusive skin wrapping of very preterm infants prevents heat loss after delivery better than conventional drying and to evaluate if any benefit is sustained after wrap removal. Study design This was a randomized controlled trial of infants <28 weeks' gestation. The experimental group was wrapped from the neck down. Only the head was dried. Control infants were dried completely. Rectal temperatures were compared on admission to the neonatal intensive care unit immediately after wrap removal and I hour later. Results Of 55 infants randomly assigned (28 wrap, 27 control), 2 died in the delivery room and 53 completed the study. '"'rapped infants had a higher mean rectal admission temperature, 36.5degreesC (SD, 0.8degreesC), compared with 35.6degreesC (SD, 1.3degreesC) in control infants (P =.002). One hour later, mean rectal temperatures were similar in both groups (36.6degreesC, SD, 0.7degreesC vs 36.4degreesC, SD, 0.9degreesC, P =.4). Size at birth was an important determinant of heat loss: Mean rectal admission temperature increased by 0.21degreesC (95% CI, 0.04 to 0.4) with each 100-g increase in birth weight. Conclusions Polyethylene occlusive skin wrapping prevents rather than delays heat loss at delivery in very preterm infants.