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Updated: Apr 16, 2026

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Heat retention head wrap for rewarming infants undergoing cardiopulmonary bypass surgery
Karen H Sakakeeny1, Jean Anne Connor2, Pedro J Del Nido2
1Karen H. Sakakeeny is a staff nurse in the main operating room at Boston Children's Hospital, Boston, Massachusetts. Jean Anne Connor is director of nursing research in the cardiovascular program at Boston Children's Hospital and an instructor of pediatrics at Harvard Medical School in Boston, Massachusetts. Pedro J. del Nido is chief of cardiac surgery at Boston Children's Hospital and a professor of surgery at Harvard Medical School. Kirsten Odegard is a cardiac anesthesiologist at Boston Children's Hospital and an associate professor of anesthesiology at Harvard Medical School. Michele DeGrazia is director of nursing research in the neonatal intensive care unit at Boston Children's Hospital and an instructor of pediatrics at Harvard Medical School. Karen.sakakeeny@childrens.harvard.edu.
Background:
A major postoperative problem for infants undergoing cardiopulmonary bypass surgery is hypothermia.
Objective:
To determine the safety and feasibility of a newly designed Heat Retention Head Wrap on infants during the rewarming period of cardiopulmonary bypass surgery.
Methods:
A sample of 10 infants was recruited into this descriptive pilot study. The health care providers completed ease-of-use questionnaires to describe the feasibility of the head wrap. Interval body temperatures were recorded to characterize temperature progression from onset of rewarming to arrival in the cardiac intensive care unit (ICU) and were compared with the temperature progression of a similar group of nonparticipants. Adverse events were recorded on the basis of perioperative body temperatures and skin assessments.
Results:
The head wrap was easily applied to the infant's head and was removed without difficulty. A steady increase in median body temperature from (1) the onset of rewarming (28°C), to (2) removal of bypass cannulas (28.9°C), to (3) removal of the rectal temperature probe before transfer from the operating room to the cardiac ICU (34.5°C), and (4) upon arrival in the cardiac ICU (36.0°C) was observed. No skin lesions or temperature-related adverse events were observed.
Conclusions:
The newly designed Heat Retention Head Wrap was associated with a gradual normalization of temperature during rewarming and did not interfere with routine perioperative care of infants undergoing bypass surgery. This pilot study indicates that the head wrap is both safe and feasible for use in infants undergoing cardiopulmonary bypass surgery.
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