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Neonatal Pathophysiology > Thermoregulation > Flashcards

Flashcards in Thermoregulation Deck (62)
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1

What is the neutral thermal environment?

an environment that is able to regulate heat production using minimal amounts of oxygen and glucose; the maintenance of a delicate balance between heat production and heat loss

2

What is the risk to the NTE at delivery?

an infant's temp can drop 2-3degrees, putting the babe at risk for hypothermia with resultant hypoglycemia, neurologic sequelae and death

3

What is a neonate's normal core temperature?

97.7-99.5

4

What are the classifications of hypothermia?

mild, moderate and severe

5

How is mild hypothermia defined?

96.8-97.6

6

How is moderate hypothermia defined?

89.6-96.6

7

How is severe hypothermia defined?

<89.6

8

In 1995, Beeram et al reported what consequences were a/w hypothermia?

an 11 fold increase in infant mortality when infants were born; hypothermia found in 60% of non-surviving infants

9

In 1999, Hulsey reported what neurologic implications a/w hypothermia?

surviving hypothermic infants had significantly more CNS disorders and rates of IVH

10

What are risk factors for temperature instability?

SGA, preterm, CNS abnormalities/damage, endocrine problems, hypoglycemia, cardiorespiratory abnormalities, abdominal wall defects, neuromuscular abnormalities, sepsis and spinal defects

11

How developed is shivering thermogenesis in the newborn?

very poorly developed

12

What is non-shivering thermogenesis?

metabolic pathway that is the main method of heat production for the newborn- utilizes brown fat metabolism

13

What is the only fx of brown fat?

to produce heat

14

What is required in the process of non-shivering thermogenesis?

O2 and glucose- this is why thermoregulation, a normal glucose level and adequate oxygenation are so closely linked

15

What is thermostability?

in an optimal situation, the newborn will maintain their core temp WNL within a wide range of ambient temp variation without increased O2 consumption or increased metabolic rate

16

Where is brown fat located?

axilla, nape of the neck, between the scapulas, mediastinum and around the kidneys

17

When do brown fat stores increase postnatally?

increase until 3-5 weeks postnatal life

18

What is the mechanism for non-shivering thermogenesis?

with the onset of cold stress, the hypothalamus detects this state and secretes epinephrine to produce vasoconstriction and to signal brown fat metabolism

19

What is responsible for temperature control?

the hypothalamus

20

What is the body's method for regulating against hyperthermia?

peripheral vasodilation to allow heat to reach the skin's surface, also results in insensible water losses that allows for the dissipation of heat; respiratory center is stimulated to increase RR to release heat via the lungs

21

What are the mechanisms for heat transfer?

conduction, convection, evaporation and radiation

22

What is conduction?

heat transfer by direct contact; degree of heat loss varies with exposed surface area

23

What factors increase an infant's risk to heat loss via conduction?

decreased ability to flex extremities, decreased subQ fat and limited ability to vasoconstrictor peripheral blood vessels

24

How can heat loss via conduction be minimized?

swaddling, skin to skin, prewar all equipment before contact with infant's skin

25

What is convection?

heat loss from air current that move heat away from the body; affected by ambient temperature, air flow velocity and relative humidity

26

How can heat loss via convection be accelerated?

when the environmental temperature is cooler and/or air flow velocity is higher

27

What are common ways that neonates loose heat via convection?

heat is swept away by drafts, air currents, AC, doors, windows, fans, open incubator portholes or "traffic" around the baby's bed

28

How can heat loss via convection be minimized?

keep warmer sides up, cover with plastic, tx in preheated warmers, warm and humidify O2 prior to use, use incubator, move beds away from drafts or vents, dress and swaddle baby in pre warmed linens

29

What is evaporation?

liquid in converted into vapor, major source of heat loss at delivery and with bathing; heat is lost through the skin and respiratory tract (insensible water loss)

30

What is heat loss via evaporation dependent upon?

air speed and relative humidity