Thermoregulation in NICU - what does it have to do with hypoxia?

[LR_C]

Hello all,

I'm doing some research about NICU and I came across Thermoregulation. I'm so confused at the relationship between hypothermia and :

- hypoxia

- acidosis

- hypoglycemia

- pulmonary vasoconstriction

If anyone could explain any of the above to me, it would be VERY much appreciated.

[dixRN]

Get the S.T.A.B.L.E. book. It gives a very clear picture of what you asked. Better yet take the one day course.

[sherirn127]

Google the Neonatal Energy Triangle. Its a great article that tells the correlation.

[NicuGal, MSN, RN]

Think about it....when you are using all your energy to stay warm, how does it affect the body?

[prmenrs, RN]

Think about it....when you are using all your energy to stay warm, how does it affect the body?

Don't forget that newborns can't do this task efficiently, there are leftovers--they cause the problem.

And you thought they made you memorize that ATP/Kreb's cycle thing for fun!!

[NicuGal, MSN, RN]

Yup...I keep telling my HS daughter that the Kreb's cycle will haunt her for the rest of her days lol

[prmenrs, RN]

What's the correct name for that thing these days? I don't think it's Kreb's cycle anymore, and I'd sure hate to date myself.

[HeartNIC]

Okay, so you have a cold baby, neonates have very limited ability to respond to cold stress. A physiologic consequence of cold stress is increased O2 consumption. This causes O2 needs to increase which can lead to hypoxia and lactic acid production. Once that starts happening ph is effected causing metabolic acidosis which leads to pulmonary vasoconstriction. Cold stress also increases metabolism. Increased metabolism increases the use of glucose. Once the circulating glucose is used the body turns to the glycogen stores and if it goes on for too long depletes glycogen stores leading to hypoglycemia.

Then on top of all that, Surfactant production becomes a problem as it requires oxygen, glucose, and good lung perfusion.

Neonates have very little reserves so depending on the gestational age and size of the infant all of this can happen very quickly and be extremely difficult to recover from leading to even more problems.