Intervention Review

Radiant warmers versus incubators for regulating body temperature in newborn infants

  1. Vicki Flenady1,*,
  2. Paul G Woodgate2

Editorial Group: Cochrane Neonatal Group

Published Online: 20 OCT 2003

Assessed as up-to-date: 12 JAN 2005

DOI: 10.1002/14651858.CD000435

How to Cite

Flenady V, Woodgate PG. Radiant warmers versus incubators for regulating body temperature in newborn infants. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD000435. DOI: 10.1002/14651858.CD000435.

Author Information

  1. 1

    Mater Health Services, Mater Mother's Research Centre, Wooloongabba, Queensland, Australia

  2. 2

    Mater Mothers' Hospital, Dept of Neonatology, South Brisbane, Queensland, Australia

*Vicki Flenady, Mater Mother's Research Centre, Mater Health Services, Level 2 Quarters Building, Annerley Road, Wooloongabba, Queensland, 4102, Australia.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 OCT 2003




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要


The provision of a thermoneutral environment is an essential component of the immediate and longer term care of newborn infants. A variety of methods are currently employed including incubators and open-care systems, with or without modifications such as heat shields and plastic wrap. The system used must allow ready access to the infant but should also minimise alterations in the immediate environment.


To assess the effects of radiant warmers versus incubators on neonatal fluid and electrolyte balance, morbidity and mortality.

Search methods

The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of electronic databases: Oxford Database of Perinatal Trials, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966 -2005), and CINAHL (1982-2005), previous reviews including cross references, abstracts, conferences, symposia proceedings, expert informants and journal hand searching mainly in the English language.

Selection criteria

Randomised or quasi-randomised trials in which radiant warmers were compared to incubators in a neonatal population.

Data collection and analysis

Independent data extraction and quality assessment of included trials was conducted by the authors. Data were analysed using relative risk (RR) and weighted mean difference (WMD). Results are presented with 95% confidence intervals. Meta-analysis was undertaken using a fixed effect model.

Main results

Eight studies are included in this review; six employed a crossover design. In the overall comparison of radiant warmers vs incubators, radiant warmers caused a statistically significant increase in insensible water loss (IWL) [WMD 0.94g/Kg/day (95% CI 0.47, 1.41)] and a trend towards increased oxygen consumption which was not statistically significant [WMD 0.27mL/kg/min (95% CI -0.09, 0.63)]. Due to small numbers, effects on important clinical outcomes could not be adequately assessed. A comparison of radiant warmers with heat shields vs incubators without heat shields showed a trend for increased IWL in the radiant warmer group, which was not statistically significant. No difference was shown in oxygen consumption.

Authors' conclusions

Radiant warmers result in increased IWL compared to incubators. This needs to be taken into account when calculating daily fluid requirements. The results of this review do not provide sufficient evidence concerning effects on important outcomes to guide clinical practice. Further randomised controlled trials are required to assess the effects of radiant warmers versus incubators in neonatal care on important short and long term outcomes, with particular attention to extremely low birthweight infants in the early neonatal period.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Radiant warmers versus incubators for regulating body temperature in newborn infants

Not enough evidence to show the effects of radiant warmers versus incubators for regulating body temperature in newborn babies.

Low birthweight babies have a higher chance of survival if they are kept warm. Incubators have been used for some time to maintain body temperature. More recently, open cots with an overhead radiant warmer have also been used for babies needing intensive care.
The review of trials found that radiant warmers increase water loss in low birthweight babies in the newborn period when compared to incubators and that this water loss needs to be taken into account when daily fluid requirements are calculated. However, there was not enough information available for this review to enable assessment of other important effects of radiant warmers. Therefore, at the present time, it is not clear which method of maintaining body temperature is best for newborn babies - radiant warmers or incubators. More research is necessary.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要







利用Cochrane Neonatal Review Group的標準搜尋策略,包含搜尋電子資料庫: Oxford Database of Perinatal Trials、Cochrane Central Register of Controlled Trials (CENTRAL, Cochrane Library, Issue 1, 2005) 、MEDLINE (1966年2005年) ,以及CINAHL (1982年2005年) 、先前的文獻回顧,包括交叉對照參考資料、摘要、研討會及座談會手冊、專家資訊,及人工搜尋以英文為主之期刊。




由各個作者針對收錄之試驗獨立進行數據摘錄及品質評估。使用相對風險 (relative risk;RR) 及加權平均差 (weighted mean difference;WMD) 分析數據。結果結合95% 信賴區間 (95% CI) 表示。整合分析係使用固定效果模型進行。


本回顧共收錄8項試驗;其中6項使用交叉設計。在輻射加溫器相對於保溫箱之整體比較中,輻射加溫器在統計學上有意義地有較多無感覺性水份流失 (insensible water loss;IWL) [WMD 0.94公克/公斤/天 (95% CI 0.47, 1.41)],並且有氧氣消耗量增加之傾向[WMD 0.27毫升/公斤/分鐘 (95% CI −0.09, 0.63)],但不具統計學上之意義。由於樣本數量過少,茲無法適當評估其對重要臨床結果之效應。其中1項針對具有隔熱板之輻射加溫器與無隔熱板之保溫箱所進行的比較中,其顯示輻射加溫器組具有IWL增加之傾向,但其不具統計學上之意義。在氧氣消耗量方面並未顯示具有差異。




此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。