Embrace^TM Versus Conventional Care during Transport of Newborn >1500 Grams: A Randomized Double Blind Controlled Trial at Tertiary Care Centre In Gujarat, India.

Background:

Neonates are prone to develop hypothermia during transport especially in resource poor settings. The Embrace^TM is a small sleeping bag-like apparatus . The Embrace^TM are composed of three components: an infant-sized sleeping bag or baby interface, a pouch of phase change material (PCM), and a heater. Embrace^TM may be used to prevent neonatal hypothermia during transport.

Objective:

We decided to assess effectiveness of Embrace^TM vs conventional care during transport from emergency department (ED) to Neonatal Intensive Care Unit (NICU).

Methods:

All neonates weighing >1500 grams coming to ED were included. During stay in ED, neonates were placed in open warmers. Neonate was placed in Embrace^TM or Pre-Warmed linen (Control) for transport to NICU. The embrace/linen was removed and neonate was placed on radiant warmer in the NICU. Temperature was recorded again (0 hour) and at 0.25, 0.5, 1, 2, 3, 6, 12 and 24 hours of the NICU stay. The distance travelled by every neonate from the ED to NICU was 700 meter.

Results:

Socio-demographic, clinical variables were similar. Preterm were 31/60 (35%) in Embrace^TM, 19/60 (31.67%) in control. Females were 21/60 (35%) in both groups. Mean birth weight was 2.5(embrace)2.44(control). Average age at admission is 4.9 days(embrace) 3.15(control). Average time for transport was 12.3 mins(embrace) and 13 mins(control). From ED to NICU, the mean(SD) temperature difference in EMBRACE^TM group was +0.37 C (0.53) (that is the temperature increased by +0.37 degree) whereas the same was -0.37 (0.79) (that is the temperature dropped by 0.37 degrees on an average). This difference was statistically significant (p <0.001).

Conclusions:

Embrace^TM is effective in maintaining euthermia in intervention group as compared to control group for short distance neonatal transport. More studies are required to assess effectiveness for inter hospital transfers of prolonged duration/distance (few Km).