Thermoregulation protocol implementation for newborns in surgical procedures

Martins, Lucas Amaral; Silveira, Suely Pedreira Xavier da; Avila, Irene Maria Fraga Teixeira; Moraes, Jéssica Alves Sacramento de; Santos, Denise Santana Silva dos; Whitaker, Maria Carolina Ortiz; Camargo, Climene Laura de

doi:10.1590/1983-1447.2019.20180218

person Lucas Amaral Martins

school Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil.school Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado de Enfermagem. Santo Antônio de Jesus, Bahia, Brasil.

person Suely Pedreira Xavier da Silveira

school Real Sociedade Portuguesa de Beneficência, Hospital Português. Salvador, Bahia, Brasil.

person Irene Maria Fraga Teixeira Avila

school Real Sociedade Portuguesa de Beneficência, Hospital Português. Salvador, Bahia, Brasil.

person Jéssica Alves Sacramento de Moraes

school Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil.

person Denise Santana Silva dos Santos

school Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil.school Universidade do Estado da Bahia (UNEB), Departamento de Ciências da Vida, Colegiado de Enfermagem. Salvador, Bahia, Brasil.

person Maria Carolina Ortiz Whitaker

school Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil.

person Climene Laura de Camargo

school Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil.

Actions	Recommendations / Routines
To ensure environment temperature of the NICU or operating room between 23-26 ºC.	To control temperature with an ambient thermometer in the morning, afternoon and evening, and check it one hour before the procedure.
To keep the NB with temperature sensor attached to the skin for monitoring.	Before the surgical procedure, to keep sensor adhered to the skin in the right hypochondrium region and monitor thermal curve.
To keep the NB engaged in previously heated culls when removing him from the incubator or heated crib for transport.	To transport in previously heated incubator with temperature between 30-36 ºC and later adjusted according to the need of the NB.
To initiate surgical procedure only when the NB has normothermic state.	To check temperature before the surgical procedure, guaranteeing normothermia (temperature of 36.5 - 37.4 ºC).
To insert esophageal thermometer before surgical procedure for temperature monitoring.	To monitor thermal curve every 30 minutes until the end of surgery.
To use thermal blanket during large surgical procedures.	To monitor thermal blanket temperature according to the NB needs.
To administer solutions and blood products at a suitable temperature of 36.5 ºC to 37 ºC.	To check temperature of solutions and blood products with infrared thermometer.
To monitor the temperature of the NB in the NICU after the postoperative return, with a digital thermometer.	- To continue with multi-parameter monitoring at 01-hour intervals in the first 06 postoperative hours; - Every 02 hours in the first 12 hours postoperatively; - Every 03 hours after the first 12 hours after surgery.
To monitor NB temperature at 15-minute intervals in situations where the condition presents hyper or hypothermia.	- In episodes of hypothermia, to adjust incubator parameter or heated crib, increasing 0.5 ºC every 60 minutes. - In episodes of hyperthermia, to adjust parameter of incubator or heated crib, reducing 0.5 ºC every 60 minutes and assess the needs of administering antipyretics.

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