A Canadian-led study is looking at whether placing premature infants in plastic bags for the first hour or two of life will not only reduce heat loss but also improve their long-term health and chances of survival.
In the high-tech world of neonatal intensive care units, it's a three-cent solution to a common and potentially dangerous problem — the rapid loss of body temperature when the amniotic fluid that babies are born doused in starts to evaporate, cooling their skin.
"Everything out there now is a million-dollar piece of equipment. It's not often you get a three-cent bag that [can] make potentially an impact around the world," said Maureen Reilly, a respiratory therapist and a principal investigator in the Heat Loss Prevention Trial.
Reilly and co-investigator Dr. Sunita Vohra, both based at Toronto's Sunnybrook Health Sciences Centre, are collaborating with neonatal intensive care units around the world on the multi-year trial. The research is funded by the Canadian Institutes of Health Research.
When babies are born, they are typically cleaned up and placed naked under a heating lamp while a number of necessary procedures are done. But preemies have both more medical needs and less ability to control their body temperature.
"As soon as the babies are born, we dry them off. And a bigger baby can tolerate the wetness. But the little ones — they're so fragile. Even though we dry them off really quickly, they still do get cold," Reilly said.
Small pilot studies have shown that wrapping these babies in plastic — plastic bags or even cling wrap — can keep them from cooling down while they undergo X-Rays, have intravenous lines inserted or are put on a ventilator.
"Basically, you could use anything. But what it has to do is prevent the evaporative heat loss, but still allow the heat from the over-bed warmer to penetrate through the bag to the baby," Reilly said.
What isn't clear, though, is whether there are any long-term gains. Are babies that have been wrapped in plastic less likely to get sick in the period after their birth? Are they more likely to survive than other preemies? Does it make a difference to their long-term neurological development?
Researchers hope the trial will answer those questions over the five or six years it will take to gather all the data. During its course, 1,685 premature babies, born at 28 weeks gestation or less, will be randomly assigned — with the consent of their parents — to either receive standard treatment or to be put in a plastic bag.
The bag, which does not cover the head, has an opening that gives health professionals access to the umbilical cord. Babies placed in a bag are worked on under a heat lamp, as are non-bagged babies. Bagged babies are eventually cleaned up when they are placed in a heated incubator.
-CBC News
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