Background Hypothermia, particularly during stabilisation and invasive procedures is recognised as a contributor to perinatal morbidity in preterm infants.1 Water-filtered IR-A (WIRA) has been used successfully for warming in neonates. Advantages compared with conventional management are its ability to pass through incubator walls and reduced evaporative water loss.2

Methods Infants below 28 weeks gestation requiring umbilical line insertion were randomly assigned to be managed either in an incubator using air control or in an incubator using air control plus a WIRA lamp during the procedure. Axillary temperature before and at completion of the procedure was recorded.

Results Total of 44 infants were randomly assigned. Data were analysed on an intention to treat basis. There was no significant difference in baseline characteristics between the two groups. The admission temperature was similar between the two groups. The median (interquartile range) preprocedure temperature in the conventional group was 36.8°C (36.5–37.6) versus 37.1°C (36.7–37.4) in the WIRA group (p>0.05). The median temperature post-procedure was 37°C (36.3–37.7) in the conventional group versus 37.4°C (36.9–38.2) in the intervention group and this reached statistical significance (p = 0.04).

Conclusions WIRA was more effective in maintaining temperature than conventional warming but caution is required to avoid overheating.