RESUMEN
OBJECTIVE: To determine whether early polyethylene bag use with skin-to-skin care compared with skin-to skin care alone reduce hypothermia among infants born at term in resource-limited settings. STUDY DESIGN: Infants born at term in the tertiary referral center in Lusaka, Zambia, were randomized using sequentially numbered sealed opaque envelopes in 2 phases: after birth (phase 1) and at 1 hour after birth (phase 2) to either skin-to-skin care with polyethylene bags or skin-to-skin care alone. Infant and maternal temperatures were recorded at birth, 1 hour, and every 4 hours until discharge or 24 hours. RESULTS: We enrolled 423 infants from May 2017 to August 2017. The rate of moderate-severe hypothermia (temperature <36.0°C) at 1 hour was 72 of 208 (34.6%) in the skin-to-skin care with a polyethylene bag group compared with 101 of 213 (47.4%) in the skin-to-skin care alone group (relative risk, 0.71; 95% CI 0.56-0.90; P < .01; number needed to treat = 8). phase 1 treatment assignment significantly modified the effect of phase 2 treatment (P = .02 for interaction effect). Among infants randomized to skin-to-skin care with a polyethylene bag in phase 1, the risk of moderate-severe hypothermia was decreased in infants randomized to continue this intervention until discharge compared with infants randomized to skin-to-skin care alone. The rates of severe hypothermia, hyperthermia, and other adverse events did not differ significantly between groups. CONCLUSIONS: Low-cost polyethylene bags started after birth in combination with skin-to-skin care reduced moderate or severe hypothermia at 1 hour and at discharge among infants born at term in a resource-limited setting compared with skin-to-skin care alone. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03141723.
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Hipotermia/prevención & control , Método Madre-Canguro , Polietileno/uso terapéutico , Ropa de Protección , Terapia Combinada , Femenino , Humanos , Hipotermia/diagnóstico , Recién Nacido , Masculino , Resultado del TratamientoRESUMEN
As a kind of polymer material additive, phthalic acid esters (PAEs) are widely used in food industry. However, PAEs are environmental endocrine disruptors with reproductive toxicity and teratogenic carcinogenicity, which are difficult to be degraded in the natural environment. In this paper, gas chromatography-mass spectrometer (GC-MS) methods for PAEs in polyethylene wrap film were optimized. For diisobutyl phthalate (DIBP) and dibutyl phthalate (DBP) that were mainly detected, the method had a good linearity in 1 to 500 ng/g. Then, we confirmed that the migration of DIBP and DBP from polyethylene wrap film increased with time and temperature. It is found that the migration law in different food simulations well followed the migration dynamics first-level model. The rate constant K1 and initial release rate V0 are inversely proportional to the polarity of the simulated liquid. We hope that this study can serve as a valuable reference for further research on the migration of food packing materials. PRACTICAL APPLICATION: In this paper, we present a simple example of applying migration model to evaluate the migration behaviors of PAEs in food packaging materials along with their hazardous properties. It can serve as a valuable reference for further research on the migration of food packing materials.
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Embalaje de Alimentos/instrumentación , Ácidos Ftálicos/química , Polietileno/química , Dibutil Ftalato/análogos & derivados , Dibutil Ftalato/química , Cromatografía de Gases y Espectrometría de Masas/métodos , Polímeros/químicaRESUMEN
BACKGROUND: Occlusive body wrap using polyethylene plastic applied immediately after birth had been shown to reduce hypothermia among preterm infants. Various adjunct methods have been studied in an attempt to further reduce the incidence of hypothermia. This study was conducted to determine whether polyethylene cap is more effective than cotton cap as an adjunct to polyethylene occlusive body wrap in reducing hypothermia in preterm infants. METHODS: The subjects consisted of preterm infants 24-34 weeks' gestation born at Universiti Kebangsaan Malaysia Medical Centre. Infants were randomly assigned to NeoCap or control groups. Infants in both groups were wrapped in polyethylene sheets from the neck downwards immediately after birth without prior drying. Infants in the control group had their heads dried and subsequently covered with cotton caps while infants in the NeoCap group had polyethylene caps put on without drying. Axillary temperature was measured on admission to the neonatal intensive care unit (NICU), and after having been stabilized in the incubator. RESULTS: Among the 80 infants recruited, admission hypothermia (axillary temperature <36.5°C) was present in 37 (92.5%) and in 40 (100%) in the NeoCap and control groups, respectively. There was no significant difference in mean temperature on NICU admission between the two groups (35.3 vs 35.1°C, P = 0.36). Mean post-stabilization temperature, however, was significantly higher in the NeoCap group (36.0 vs 35.5°C, P = 0.01). CONCLUSION: Combined use of polyethylene body wrap and polyethylene cap was associated with a significantly higher mean post-stabilization temperature compared with polyethylene body wrap and cotton cap.
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Vendajes , Vestuario , Fibra de Algodón , Hipotermia/prevención & control , Enfermedades del Prematuro/prevención & control , Cuidado Intensivo Neonatal/métodos , Polietileno , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Resultado del TratamientoRESUMEN
OBJECTIVE: To examine the effects of using vinyl isolation bags or polyethylene wrap for the prevention of postnatal hypothermia in preterm infants at ≤ 32 weeks gestation. DESIGN: A prospective, randomized controlled trial. SETTING: The neonatal intensive care unit (NICU) of the Istanbul Faculty of Medicine in Turkey. PARTICIPANTS: Fifty-nine preterm infants. METHODS: Participants were randomly assigned to either the vinyl isolation-bag experimental group (n = 22) or the polyethylene-wrap control group (n = 37). Infant body temperature was measured at four time points after birth. RESULTS: Loss of body temperature was significantly less in the vinyl isolation-bag group during the first 60 minutes after birth (p = .041). Body temperature decreased by 1.41 ± 1.65 °C in the vinyl isolation-bag group and 2.75 ± 1.68 °C in the polyethylene wrap group. Body temperature was significantly less in the polyethylene wrap group compared to the vinyl isolation-bag group at birth to 60 minutes (p = .004). CONCLUSION: Wrapping preterm infants of gestational age ≤ 32 weeks in vinyl bags immediately after birth is associated with lower incidences of hypothermia.
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Hipotermia/prevención & control , Cuidado del Lactante/métodos , Enfermedades del Prematuro/prevención & control , Ropa de Protección , Temperatura Corporal , Regulación de la Temperatura Corporal/fisiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Masculino , Polietileno , Estudios Prospectivos , Resultado del Tratamiento , Turquía , Compuestos de ViniloRESUMEN
INTRODUCTION: Immediate postnatal hypothermia is an independent risk factor for death in premature newborns. Three randomized controlled trials (RCTs) and five historical controlled trials show statistically significant differences in admission temperature between infants wrapped in occlusive skin wrap and unwrapped infants. This paper presents a study protocol for The Vermont Oxford Network (VON) Heat Loss Prevention (HeLP) Trial, a multicentre RCT of two interventions (standard of care vs. occlusive wrap) that investigates the effect of polyethylene occlusive wrap applied immediately after birth on mortality in infants born 24 + 0/7 to 27 + 6/7 week gestation. METHODS: Inclusion criteria include: infants 24 + 0/7 to 27 + 6/7 weeks gestational age and a firm decision prior to birth to provide full resuscitative measures. Exclusion criteria comprise infants born with blistering skin conditions or congenital anomalies that are not covered by skin. The primary outcome measure is all-cause mortality until discharge from the hospital or at six months corrected gestational age. The secondary outcome measures include baseline and post-stabilization axillary temperatures, acidosis, hypotension, hypoglycaemia, seizures in the first 12h, patent ductus arteriosus, and respiratory distress syndrome. Long-term follow-up at 18 to 24 months corrected age will be assessed with the combined risk of death and major neurosensory disability as the primary outcome. DISCUSSION: Key covariates and protocol deviations are addressed and steps to monitor these are described. Wrapping may prove an inexpensive and easy method to benefit premature newborns in level I and II nurseries, in both developed and developing countries, as well as large tertiary care centres. REB APPROVAL: Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada-355-2003 University of Alberta, Edmonton, Alberta, Canada-Pro00003810 Vermont Oxford Network, Burlington, Vermont, USA-CHRMS: M04-295.