Mode of Action, Efficacy, and Safety of Radiant Warmers in Neonatology

Given the serious adverse effects of hypothermia in term and preterm infants, thermal protection is of paramount importance in neonatal care. To compare potential benefits of wIRA radiators with conventional radiant warmers in neonatology, physical investigations (agar phantoms) and clinical observations (term and preterm neonates) were performed. Physical investigations revealed a fundamental difference in the mode of action between the two types of radiation: Whereas with conventional radiant warmers, the increase in core temperature (phantoms) is preceded by marked elevations in surface temperature, wIRA leads to more direct rises in core temperature and results in smaller amounts of evaporative water loss from the surface. Clinical observations reveal that wIRA causes less skin surface warming than conventional heat irradiation at equal power densities (irradiances). wIRA used as a supplementary source of heat during primary care in the delivery room was found to exert a preventive effect against unintentional heat loss during the subsequent incubator transport of preterm neonates to the intensive care unit. Overall, due to its specific physical properties (“enhanced depth effect with less surface overheating”), wIRA seems to be particularly suited to replace the extra heat losses occurring in preterm or otherwise compromised neonates without undue risk of superficial burns.