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Thermoregulation in the Neonate

Thermoregulation in the Neonate. Presented by Fred Hill, MA, RRT. Minimize Cold Stress. Heat Production and Metabolism. Heat production is byproduct of normal metabolism To maintain constant body temperature: heat of metabolism = heat loss

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Thermoregulation in the Neonate

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  1. Thermoregulation in the Neonate Presented by Fred Hill, MA, RRT

  2. Minimize Cold Stress

  3. Heat Production and Metabolism • Heat production is byproduct of normal metabolism • To maintain constant body temperature: heat of metabolism = heat loss • Homeotherm: An organism that can increase heat production in a cool environment • Poikilotherm: snake, lizard, frog, etc.

  4. Response to Cooling: Adult • Voluntary Muscle Activity • Shivering (involuntary muscle activity) • Nonshivering thermogenesis (involuntary)

  5. Response to Cooling: Baby • Nonshivering thermogenesis (involuntary) – primarily brown fat metabolism • Brown fat • Nape of the neck • Between scapulae • Mediastinum • Surrounding kidneys and adrenals

  6. Brown Fat Characteristics • Rich in mitachondria • Numerous fat vacuoles • Dense capillary network • Highly innervated with sympathetic nerve endings • Oxidation to heat as opposed to ATP

  7. Why babies lose heat easily • Large surface-to-volume ratio • Thin, more permeable skin • Less insulating subcutaneous fat • Unable to shiver

  8. Mechanisms of Heat Loss • Radiation • Conduction • Convection • Evaporation

  9. Vicious Cycle of Cooling

  10. Neutral Thermal Environment

  11. Neutral Thermal Environment • Reduces insensible water loss • Reduces caloric needs for growth • Comparison study • Neutral thermal environment (36.5O): grew faster • Standard group (35O): Better cold resistance • Comparable growth achieved with standard conditions by increasing calories

  12. Strategies for Reducing Heat Loss • Radiant warmers • Double-walled isolets • Cover with blanket • Hats • Plastic wrap • Heated water-filled mattress • Keep away from air conditioning ducts

  13. Strategies for Resuscitation • Dry infant - reduce evaporative heat loss • Place on a blanket - reduce conductive heat loss • Radient warmer - counteracts radiant heat loss • Protect from air currents - reduces convective heat loss

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