The following is a summary of “Introduction of a Warming Bundle to Reduce Hypothermia in Neonatal Surgical Patients,” published in the February 2024 issue of Pediatrics by Ramjist et al.

Addressing the substantial morbidity and mortality associated with hypothermia in neonatal surgical patients, their objective was to mitigate intra and postoperative hypothermia. Commencing in November 2021, the researchers introduced a comprehensive warming intervention encompassing a radiant warmer and a hat in conjunction with standard warming protocols before initiating General Surgery procedures. Core body temperature measurements were conducted preoperatively, intraoperatively, and postoperatively. Prospective data collection from electronic medical records spanned from July 2021 to March 2023, with a retrospective analysis performed. 

Hypothermia, defined as a temperature < 36.5°C, was assessed, and control charts were generated to evaluate the impact of the interventions. Out of 277 identified procedures, including 226 abdominal, 31 thoracic, 14 skin/soft tissue, and 6 anorectal procedures, the median post-natal age was 36.1 weeks, pre-surgical weight was 2.3 kg, and operative duration was 181 minutes. Hat and warmer data were unavailable for 59 procedures, with hat and warmer utilized in 51% of procedures, hat alone in 29%, warmer alone in 10%, and neither in 10% of procedures. A noteworthy increase in hat utilization was observed over time, while warmer usage remained unchanged. Significantly, there was an increase in the mean lowest intraoperative temperature and a reduction in the proportion of hypothermic patients intraoperatively and postoperatively. 

In conclusion, integrating a radiant warmer and hat effectively decreased the incidence of hypothermia among neonatal surgical patients throughout and after surgery. Further investigations are warranted to discern the impact of these interventions on broader surgical outcomes.

Source: sciencedirect.com/science/article/abs/pii/S002234682400068X