Removing smAll BaBies from incubators to coT (RABBIT): A quasi-experimental design study with comparison arm

Aim: To assess if small or premature neonates can maintain thermal stability during the first seven days, when weaned from incubator to open cots following a pre-specified weaning protocol, compared to a retrospective control weaned without pre-defined criteria. Methods: This quasi-experimental study included infants born at < 34 weeks gestational age or birthweight less than 1400 g and needing incubator care for at least 72 h. An infant was deemed suitable for weaning at 34 weeks corrected gestational age (or at 1400 g regardless of gestational age) provided the infant maintained an axillary temperature ≥36.7⁰Celsius on a servo-control set at 36.0⁰Celsius, and the incubator air temperature averaged ≤27⁰Celsius for at least 48 h. Upon transferring to the cot, a pre-designed flow chart was placed next to the baby, with a view to maintain axillary temperature. The prospective intervention group was compared with the retrospective control group. Results: The study enrolled 63 babies in the intervention study group compared with 65 retrospective controls. There was no significant difference in axillary temperature between intervention and control groups. No baby was returned to the incubator due to failure to maintain temperature. However, there was an increased weight gain from birth weight to discharge and post one week transfer into the cot for the intervention study group of babies in comparison to the retrospective control group. Conclusion: Temperature maintenance in babies weaned using standardised protocol was similar to the control group. However, better weight gain was seen in the study group.