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Updated: May 23, 2025
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Comparison between upper body and full underbody forced-air warming blanket in pediatric patients undergoing
Jung-Bin Park1, Tae-Won Kim1, Sang-Hwan Ji1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03070, Republic of Korea.
Insights
For pediatric cardiovascular interventions, both upper body and full underbody forced-air warming blankets are similarly effective in maintaining target temperatures. Careful monitoring is crucial to prevent complications like hyperthermia and skin issues.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Cardiovascular Surgery
Background:
- Pediatric patients undergoing non-operating room cardiovascular interventions face significant risks of perioperative hypothermia.
- Maintaining normothermia is critical for patient safety and optimal outcomes during these procedures.
Purpose of the Study:
- To compare the efficacy of upper body versus full underbody forced-air warming blankets in pediatric patients during general anesthesia for cardiovascular interventions.
- To assess the time-weighted deviation of esophageal temperature outside the target range (36.5-37.5°C) between the two warming methods.
Main Methods:
- A randomized controlled trial involving 88 children (<15 years) undergoing elective cardiovascular interventions.
- Patients were assigned to either upper body or full underbody forced-air warming blanket groups.
- Esophageal temperature was monitored, and the primary outcome was the time-weighted average deviation from the target temperature range.
Main Results:
- No significant difference was found in the time-weighted average temperature deviation between the upper body and full underbody groups (p=0.318).
- The incidence of hyperthermia was 9.09% in the upper body group versus 0% in the full underbody group (p=0.125).
- Hypothermia duration and adverse event rates showed no statistically significant differences between the groups.
Conclusions:
- Both upper body and full underbody forced-air warming blankets demonstrate comparable effectiveness in maintaining perioperative normothermia in pediatric cardiovascular interventions.
- Close patient monitoring remains essential to prevent potential complications such as hyperthermia and skin-related issues.
Background:
Pediatric patients undergoing cardiovascular interventions outside the operating room are at high risk of perioperative hypothermia. We aimed to compare the effects of upper body and full underbody forced-air warming blankets on the time-weighted deviation of esophageal temperature outside the target range (36.5-37.5 °C) during general anesthesia.
Methods:
In this randomized controlled study, 88 children (age < 15 years) scheduled for elective cardiovascular interventions under general anesthesia were randomly assigned to the upper body (n = 44) or full underbody (n = 44) group. After the induction of anesthesia, warming blankets were applied and heated using a forced-air warmer to maintain an esophageal temperature of 36.5-37.5 °C. The primary outcome was the time-weighted average deviation of esophageal temperature outside the desired range, defined as the total deviation in temperature divided by the duration spent outside the target range. Secondary outcomes included use of additional warming or cooling methods, temperature trends, thermal comfort, and adverse events. Statistical comparisons were performed using t-tests or chi-square tests, with p < 0.05 considered significant.
Results:
The time-weighted averages of periods out of the desired temperature range were comparable between the two groups (upper body vs. full underbody, 0.213 ± 0.212 °C vs. 0.265 ± 0.277 °C; mean difference, 0.053; 95% confidence interval [CI], - 0.052 to 0.157; p = 0.318). The incidence of hyperthermia (> 37.5 °C) was 9.09% (upper body) and 0% (full underbody, p = 0.125). The duration of hypothermia (< 36.5 °C) was 58.82 ± 48.83 min (upper body) and 70.03 ± 53.20 min (full underbody; mean difference, 11.20 min; 95% CI, - 10.44 to 32.85; p = 0.318). The incidence rates of adverse events were 4.55% (upper body) and 15.91% (full underbody, p = 0.159).
Conclusions:
Both warming methods showed comparable time-weighted averages of temperatures outside the desired range, suggesting similar effectiveness. However, careful monitoring is essential to mitigate the risks of hyperthermia and skin-related complications and ensure patient safety during pediatric cardiovascular interventions.
Trial Registration Number:
NCT05349734 (registered at clinicaltrials, principal investigator: Hee-Soo Kim, registration date: April 26,2022).
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