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Head cooling wrap could suppress the elevation of core temperature after cardiac surgery during forced-air warming in a pediatric intensive care unit: a randomized clinical trial

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Abstract

Purpose

The main aim of the current trial was to explore our hypothesis that cooling head wraps lower the core temperature more effectively than ice packs on the head during forced-air warming after pediatric cardiac surgeries.

Methods

This study was a single-center Randomized Controlled Trial. Participants were children with a weight ≤ 10 kg and hyperthermia during forced-air warming after cardiac surgeries. When the core temperature reached 37.5 °C, ice packs on the head (group C) or a cooling head wrap (group H) were used as cooling devices to decrease the core temperature. The primary outcome was the core temperature. The secondary outcomes were the foot surface temperature and heart rate. We measured all outcomes every 30 min for 240 min after the patient developed hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and also the Bonferroni test as a post hoc analysis.

Results

Twenty patients were randomly assigned to groups C and H. The series of core temperatures in group H were significantly lower than those in group C (p < 0.0001), and post hoc analysis showed that there was no significant difference in core temperatures at T0 between the two groups and statistically significant differences in all core temperatures at T30-240 between the two groups. There was no difference between the two groups’ surface temperatures and heart rates.

Conclusions

Compared to ice packs on the head, head cooling wraps more effectively suppress core temperature elevation during forced-air warming after pediatric cardiac surgery.

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Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

No funding was received to assist with the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, 006-0041, Japan

    Wataru Sakai, Tomohiro Chaki, Yuko Nawa, Takayoshi Oyasu, Yuki Ichisaka, Tomohiro Nawa, Hidetsugu Asai, Noriyoshi Ebuoka & Junichi Oba

  2. Department of Anesthesiology, Sapporo Medical University School of Medicine, East 17, South 1, Chuo-Ku, Sapporo, Hokkaido, 060-8556, Japan

    Wataru Sakai, Tomohiro Chaki, Yuko Nawa & Michiaki Yamakage

  3. Department of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, 006-0041, Japan

    Yuki Ichisaka, Hidetsugu Asai, Noriyoshi Ebuoka & Junichi Oba

Authors
  1. Wataru Sakai
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  2. Tomohiro Chaki
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  3. Yuko Nawa
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  4. Takayoshi Oyasu
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  7. Hidetsugu Asai
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  10. Michiaki Yamakage
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Contributions

WS: This author served as the global chief investigator for this study, designed the study, analyzed and interpreted the data, and drafted the manuscript. TC: This author designed the study, helped with experiments, analyzed and interpreted the data, revised the work critically, and proofread the manuscript draft. YN: This author designed the work, helped with the experiments, interpreted the data, and revised the work critically. TO: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. YI: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. TN: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. HA: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. NE: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. JO: This author designed the study, helped with clinical management, interpreted the data, and revised the study critically. MY: This author designed the study, acquired the work, analyzed and interpreted the data, and revised the study critically. WS, TC, YN, TO, YI, TN, HA, NE, JO, and MY drafted the study, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work was appropriately investigated and resolved.

Corresponding author

Correspondence to Wataru Sakai.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest associated with this manuscript.

Ethical approval

The study was approved by the ethics committee of the Hokkaido Medical Center for Child Health and Rehabilitation (Trial ID:42-4). The trial was registered in the jRCT Clinical Trial Registry (ID: jRCT1012210039, URL: https://rctportal.niph.go.jp/en/detail?trial_id=jRCT1012210039, principal investigator’s name: Wataru Sakai, registration day: October 13, 2021) and performed in accordance with the Declaration of Helsinki after approval from the ethics committee.

Consent to participate

Written consent was obtained from the parents of the participating patients.

Consent for publication

Written consent was obtained from the parents of the participating patients.

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Cite this article

Sakai, W., Chaki, T., Nawa, Y. et al. Head cooling wrap could suppress the elevation of core temperature after cardiac surgery during forced-air warming in a pediatric intensive care unit: a randomized clinical trial. J Anesth 37, 596–603 (2023). https://doi.org/10.1007/s00540-023-03210-7

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  • DOI: https://doi.org/10.1007/s00540-023-03210-7

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