A novel thermoregulatory system maintains perioperative normothermia in children undergoing elective surgery.
BACKGROUND
Body heat loss during anaesthesia may result in increased morbidity, particularly in high-risk populations such as children. To avoid hypothermia, a novel thermoregulatory system (Allon) was devised. We tested the safety and efficacy of this system in maintaining normothermia in children undergoing routine surgical procedures.


METHODS
The system consists of a computerized body, which receives continuous afferent data, i.e. core (rectal) temperature. These data are then compared with a preset temperature (37 degrees C) and a microprocessor heating/cooling unit warms/cools the temperature of circulating water in a garment that is specially designed to allow maximal coverage of body surface area, without impingement on the surgical field. Water temperature to the garment was limited to a maximum of 39.5 degrees C. Continuous perioperative monitoring of skin and rectal temperature, heart rate and blood pressure was performed. Postoperative shivering and adverse effects were also assessed.


RESULTS
The Allon system was used in 38 patients aged 3 months to 14 years undergoing surgery under general anaesthesia lasting more than 30 min. Fifty to 80% body surface area was covered by the garment. Mean operative and postoperative core temperatures were 36.9 +/- 0.5 degrees C and 36.7 +/- 0.5 degrees C, respectively. Intraoperative skin temperatures were maintained at 34.4 +/- 2.7 degrees C. The average core- to-periphery intraoperative gradient was 2.9 +/- 4.9 degrees C. Postoperative shivering was absent in 36 cases and mild in two cases. No device-related adverse effects were observed.


CONCLUSIONS
Perioperative thermoregulation using the Allon system is safe and effective in maintaining body temperature within a narrow range in children undergoing brief surgical procedures.
Nesher
N
N
Department of Cardiothoracic Surgery, Carmel Medical Center, Haifa, Israel.
Wolf
T
T
Uretzky
G
G
Oppenheim-Eden
A
A
Yussim
E
E
Kushnir
I
I
Shoshany
G
G
Rosenberg
B
B
Berant
M
M
D000293:Adolescent; D001831:Body Temperature; D001833:Body Temperature Regulation / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006339:Heart Rate; D006801:Humans; D007035:Hypothermia / Q000209:etiology / Q000517:prevention & control*; D007223:Infant; D007430:Intraoperative Care / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D017694:Rewarming / Q000295:instrumentation*