Water and Heat – The Priority for the Newborn Infant

Maintaining fluid and heat balance is of vital importance to the newborn infant. At birth, the infant is exposed to a cold and dry environment, and preterm neonates in particular, are then at risk of dehydration and hypothermia. These conditions may have serious consequences and significantly influence mortality and morbidity. Preterm neonates have a high rate of water and heat loss mainly as a consequence of their immature skin. The care environment influences the magnitude of water and heat exchange and needs to be individually tailored on the basis of the infant's clinical status, maturity at birth and postnatal age. This paper reviews data obtained from series of studies on neonatal water and heat exchange using non-invasive measurements of insensible water loss and calculations of different modes of heat exchange. These studies have influenced the way in which newborn infants are being nursed today.

[1]  H. Versmold,et al.  Effects of Gestational and Postnatal Age on Body Temperature, Oxygen Consumption, and Activity during Early Skin-to-Skin Contact between Preterm Infants of 25-30-Week Gestation and Their Mothers , 1998, Pediatric Research.

[2]  G. Sedin,et al.  Transepidermal water loss in newborn infants. VI. Heat exchange with the environment in relation to gestational age. , 1982, Acta paediatrica Scandinavica.

[3]  G. Nilsson,et al.  Measurement of water exchange through skin , 1977, Medical and Biological Engineering and Computing.

[4]  G. Sedin,et al.  Respiratory water loss and oxygen consumption in newborn infants during phototherapy , 1992 .

[5]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS , 1983, Acta paediatrica Scandinavica.

[6]  W. Fox,et al.  Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant. , 1981, The Journal of pediatrics.

[7]  G. Sedin,et al.  Insensible water loss from the skin during phototherapy in term and preterm infants , 1992, Acta paediatrica.

[8]  J. H. Comroe,et al.  The lung : clinical physiology and pulmonary function tests : based on the 1954 Beaumont Lecture , 1955 .

[9]  G. Sedin.  To avoid heat loss in very preterm infants. , 2004, The Journal of pediatrics.

[10]  W. Oh,et al.  Phototherapy and insensible water loss in the newborn infant. , 1972, American journal of diseases of children.

[11]  A. Jonzon,et al.  HIGH‐FREQUENCY POSITIVE‐PRESSURE VENTILATION BY ENDOTRACHEAL INSUFFLATION , 1971, Acta anaesthesiologica Belgica.

[12]  G. Sedin,et al.  Water Loss from the Skin of Term and Preterm Infants Nursed under a Radiant Heater , 1995, Pediatric Research.

[13]  J. Kitterman,et al.  Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. , 1971, The New England journal of medicine.

[14]  S. Baumgart.  Reduction of oxygen consumption, insensible water loss, and radiant heat demand with use of a plastic blanket for low-birth-weight infants under radiant warmers. , 1984, Pediatrics.

[15]  G. Sedin,et al.  Measurement of respiratory water loss in newborn lambs. , 1986, Acta physiologica Scandinavica.

[16]  J. H. Comroe.  The Lung. Clinical Physiology and Pulmonary Function Tests , 1956 .

[17]  J. Stothers.  Head insulation and heat loss in the newborn. , 1981, Archives of disease in childhood.

[18]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS I. Relation to Ambient Humidity and Site of Measurement and Estimation of Total Transepidermal Water Loss , 1977, Acta paediatrica Scandinavica.

[19]  M. Weinstein,et al.  Heat balance in premature infants: comparative effects of convectively heated incubator and radiant warmer, with without plastic heat shield. , 1980, The Journal of pediatrics.

[20]  A. Fanaroff,et al.  Insensible water loss in low birth weight infants. , 1972, Pediatrics.

[21]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS , 1979, Acta paediatrica Scandinavica.

[22]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS II. Relation to Activity and Body Temperature , 1979, Acta paediatrica Scandinavica.

[23]  B. Friis‐Hansen.  Changes in Body Water Compartments during Growth , 1957, Helvetica paediatrica acta.

[24]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS , 1982, Acta paediatrica Scandinavica.

[25]  G Sjörs,et al.  Transepidermal water loss in infants born at 24 and 25 weeks of gestation , 1998, Acta paediatrica.

[26]  B. Schmidt,et al.  Heat Loss Prevention (HeLP) in the delivery room: A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants. , 2004, The Journal of pediatrics.

[27]  J. Ågren,et al.  Transepidermal Water Loss in Developing Rats: Role of Aquaporins in the Immature Skin , 2003, Pediatric Research.

[28]  E. Hey,et al.  Evaporative water loss in the new‐born baby , 1969, The Journal of physiology.

[29]  R. Kirby,et al.  A New Pediatric Volume Ventilator , 1971, Anesthesia and analgesia.

[30]  K Hammarlund,et al.  RESPIRATORY WATER LOSS IN FULLTERM INFANTS ON THEIR FIRST DAY AFTER BIRTH , 1985, Pediatric Research.

[31]  P A Oberg,et al.  Measurements of transepidermal water loss in newborn infants. , 1985, Clinics in perinatology.

[32]  G. Sedin.  Fluid management in the extremely preterm infant. , 1996 .

[33]  G. Sedin.  Chapter 57 – Physics and Physiology of Human Neonatal Incubation , 2004 .

[34]  J. Ågren,et al.  Ambient humidity influences the rate of skin barrier maturation in extremely preterm infants. , 2006, The Journal of pediatrics.

[35]  K Hammarlund,et al.  Heat loss from the skin of preterm and fullterm newborn infants during the first weeks after birth. , 1986, Biology of the neonate.

[36]  R. J. Harrison,et al.  The Lung: Clinical Physiology and Pulmonary Function Tests , 1956 .

[37]  G. Sedin,et al.  Respiratory Water Loss in Relation to Activity in Fullterm Infants on Their First Day after Birth , 1987, Acta Paediatrica Scandinavica.

[38]  J. Ågren.  Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1249 Water Transport Through Perinatal Skin Barrier Function and Aquaporin Water Channels , 2003 .

[39]  I Holmér,et al.  Assessment of Thermal Conditions in Neonatal Care: Use of a Manikin of Premature Baby Size , 1992, American journal of perinatology.

[40]  G. Sedin,et al.  TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS , 1982 .