Original ArticleHeat Loss Prevention (HeLP) in the delivery room: A randomized controlled trial of polyethylene occlusive skin wrapping in very preterm infants
Section snippets
Setting and participants
The Heat Loss Prevention (HeLP) study was conducted at McMaster University Medical Center in Hamilton, Ontario, Canada, from February 1999 to March 2000. Infants <28 weeks' gestation were potentially eligible if they were born in the study center. Infants whose delivery was not attended by the neonatal team were excluded from enrollment. The protocol also prescribed that infants were to be excluded if they had major congenital anomalies that were not covered by skin (eg, gastroschisis,
Participant flow
Figure 1 summarizes the flow of participants through the screening stage, enrollment, and completion of the study protocol. One infant who was randomly assigned to the no-wrap group was wrapped in error but analyzed according to the intended treatment. All patients were followed until death or discharge, whichever occurred first. Table I shows that the baseline characteristics of the infants and their mothers were similar in both groups.
Outcomes
The mean rectal temperature on admission to the NICU was
Discussion
We have confirmed that polyethylene occlusive skin wrapping of very preterm infants immediately after birth provides better thermal protection in the delivery room than conventional drying. Moreover, we have shown that wrapping prevents rather than just delays heat loss after very preterm birth. Wrapped infants maintained their core temperature after admission to the NICU and after wrap removal in a closed incubator. The HeLP study is the second randomized trial of this intervention. We
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Supported by the Neonatal Resuscitation Program of the American Academy of Pediatrics.