Sicherheit und Effektivität der Verwendung von Plastikfolien bei der Erstversorgung sehr kleiner Frühgeborener mit einem Geburtsgewicht <1500 g und/oder einer Reife <32 SSW

by Christina Horvath née Reuter
Doctoral thesis
Date of Examination:2024-10-11
Date of issue:2024-09-19
Advisor:Prof. Dr. Thomas, Paul
Referee:Prof. Dr. Thomas Paul
Referee:Dr. Ulrike Loderstädt
Persistent Address: http://dx.doi.org/10.53846/goediss-10737

 

 

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Abstract

English

Guidelines advise for more than 20 years to use occlusive plastic wraps for temperature management during delivery room care. In contrast, data on microbial safety and efficacy of different types of wrap are still scarce. Methodology: Heat loss protection and water retention capacity of plastic wraps were tested in vitro for a random sample of seven different types of plastic wrap with pre-warmed aluminium blocks. Thickness and composition of these wraps was determined. Wraps used during delivery room care of 27 very low birth weight infants born by elective caesarean section was analysed for microbial growth before and after use. Results: The most effective wrap extended the time to cool by 2°C twofold whereas the least effective lead to a faster heat loss compared to no wrap. Most wraps were made from polyethylene and showed a 20 fold capacity to reduce water loss. Heat and water retention did not correlate to wrap thickness. In contrast, a polyurethane wrap was far inferior in all capacities tested compared to those consisting of polyethylene and contained potentially toxic and narcotic monomers. For 24 out of 27 wraps microbiological cultures were positive whereas controls without infant contact were sterile with one exception of weak cultivation of spore formers Conclusion Occlusive plastic wrap should not stay on the newborns for a prolonged time. Large differences in heat and water retention capacity warrants a careful choice of the type of wrap as some might be contra-productive. Wraps containing polyurethane should not be used.
Keywords: delivery room care; VLBW; temperature management; heat loss protection; water loss protection; safety; plastic wrap