Abstract
Radiant warmers compare favourably with incubators for the easy access they provide to critically-ill infants without disturbing the thermal environment. The major disadvantage of radiant warmers are increased insensible water loss and increased oxygen consumption. Its cardiovascular effects are largely unknown. We measured cardiac output, stroke volume, heart rate, lower limb and skin blood flow in twenty preterm newborn infants nursed in an incubator and under a radiant warmer at an abdominal skin temperature of 36.5°C. Mean (±SE) birth weight was 1.57±0.06 kg, gestational age 31.7±0.4 wk, weight at exam 1.69±0.02 kg, and median postnatal age 15 days. Cardiac output and stroke volume were estimated using a combination of pulsed Doppler and M-mode echocardiography. Limb blood flow was measured in the right calf by strain gauge plethysmography and blood flow through the cutaneous microcirculation in the left calf by photoplethysmography.
Skin and limb blood flow increased by 44-55% with radiant heat (p<0.001 and <0.01). Cardiac output increased by 5.4% (p<0.02) under the radiant warmer secondary to a small but significant (p<0.05) rise in heart rate.
We conclude that in preterm infants, radiant heat leads to an increase in skin and limb blood flow and a small rise in cardiac output and heart rate. The changes in cardiac output are comparable to the reported changes in oxygen consumption in that situation.
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Walther, F., Wu, P. & Siassi, B. 130 CARDIOVASCULAR CHANGES IN PRETERM INFANTS NURSED UNDER RADIANT WARMERS. Pediatr Res 20, 1055 (1986). https://doi.org/10.1203/00006450-198610000-00185
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DOI: https://doi.org/10.1203/00006450-198610000-00185