Current Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.

Abstract

Abstract: The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness. Recent efforts have enhanced our understanding of the prevalence of serious infections among infants with hypothermia, although challenges remain due to lack of standardized definitions and comprehensive guidelines. There exists extensive variation in the care of young infants with hypothermia. Risk factors for serious bacterial infections in infants with hypothermia, as identified in single-center and multicenter retrospective studies, include lower temperatures, older age, and abnormalities in blood and urine testing. Given the absence of clear guidelines, management of infants with hypothermia relies heavily on clinician judgment and shared decision making, guided by individual patient assessments and risk factors. This review article summarizes existing evidence and identifies gaps in the management of infants (<90 days) with hypothermia in the emergency department.