Water-filled garment warming of infants undergoing open abdominal or thoracic surgery

We have assessed the efficacy of a water-filled garment (ThermoWrap-Allon 2001) to maintain normothermia in small infants during major open abdominal or thoracic surgery. Twenty-two patients were studied in a case-matched comparison of two methods of thermal control intended to maintain core body temperature at 37 degrees C. The standard method involved a warm air mattress with additional insulation. The ThermoWrap garment covered the head, trunk and legs and the water temperature was automatically controlled. Central and peripheral temperatures were recorded every 15 min. Nineteen infants had abdominal and three had thoracic operations. The mean weight was 3.2 kg (range 1.4-7.8 kg). Over time, the core temperature declined with standard care but not with the ThermoWrap. Core temperature was statistically lower in the standard care infants by 30 min after start of surgery. Six infants had a core temperature of less than 35 degrees C with standard care (lowest 33.7 degrees C); the lowest temperature with the ThermoWrap was 35.6 degrees C. Some infants had cold hands with the ThermoWrap. Core temperature is better preserved with the ThermoWrap; extra insulation of exposed arms may be necessary. An important advantage of the ThermoWrap is its ability to control body temperature automatically.