Preventing Inadvertent Hypothermia in Paediatric Neurosurgery in Malawi

2016-11-30 15:45:45 | BioPortfolio


We´re undertaking a randomized controlled non-inferiority trial to evaluate the ability of a simple and low-cost method (Hibler´s method of wrapping the patient in multiple insulating layers) to prevent intraoperative heat-loss in children undergoing neurosurgery under anesthesia in Malawi. Our control group will be heated actively with the use of warm-air blankets. Our aim is to evaluate whether Hibler´s method can provide a cheap and technically simple way of adequately preserving the patients´ core temperature in the operating theatre in a resource-poor setting.


Hypothermia in the perioperative setting is receiving increasing attention in anaesthetic and surgical care. The paediatric age group is arguably at increased risk and thus deserves more intensive focus.

Our aim is to undertake a randomized controlled non-inferiority study in which we compare two different modalities to prevent inadvertent intraoperative hypothermia in a paediatric neurosurgical population in a South-East African regional tertiary care hospital.

The primary objective is to determine whether a low cost and simple method can be as effective and safe as a more expensive and technically demanding method. In the study period we aim to recruit 40 patients in each of the two study arms. Patients younger than 12 years of age presenting for scheduled neurosurgery will be approached and introduced to the study. If consent (and assent, where applicable) is obtained they will be randomized to one of the two different techniques; either passive heat preservation using what has become known as Hibler´s method (interventional group) or active warming with warm-air blankets (control group). Throughout the study period core temperature will be measured continuously, both for purposes of data accuracy and to maintain safety standards.

Primary study outcomes focus on the comparative ability of the methods in maintaining acceptable core temperatures. We will also study a number of secondary end-points such as prevalence of shivering, conscious level, analgesia requirements, oxygenation and overall cost.

Upon completion of the study we will seek to publish our findings in a relevant medical journal. Presenting the results in abstract form or as a poster in an appropriate medical congress may also be desirable.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Prevention




Hibler's, Warm Air


Queen Elizabeth Central Hospital




Oslo University Hospital

Results (where available)

View Results


Published on BioPortfolio: 2016-11-30T15:45:45-0500

Clinical Trials [140 Associated Clinical Trials listed on BioPortfolio]

Effects of Insufflated Gas on Core Temperature and Post-operative Pain During Laparoscopic Surgery

During laparoscopy, administration of cold and dry carbon dioxide (CO2) leads to hypothermia. Different types of gas conditioning have been studied in order to prevent this specific hypoth...

Plastic Hat Trial to Prevent Hypothermia in Preterm Newborns in the Delivery Room

The purpose of this research project is to ascertain the effectiveness of plastic head covering in prevention of hypothermia. Hypothermia is defined by body temperature

The Effect of a Respiratory Muscle Warm-up Prior to Exercise in Patients With Chronic Obstructive Pulmonary Disease

The purpose of this study is to investigate the effects of performing a breathing muscle warm up before exercise in patients who have chronic obstructive pulmonary disease (COPD). The main...

Trial of Different Hypothermia Temperatures in Patients Recovered From Out-of-hospital Cardiac Arrest

Mild therapeutic hypothermia in the temperature range of 32º - 34ºC. improves survival in patients recovered from a ventricular fibrillation cardiac arrest. The same therapy is suggested...

Acute Effect of Static Stretching and Muscle Warming on the Functional Performance of College Volleyball Athletes

The purpose of this study is analyze the effects of static stretching and active warm up, isolated and associated, in functional performance of the lower limbs in college volleyball athlet...

PubMed Articles [382 Associated PubMed Articles listed on BioPortfolio]

The International Hypothermia Registry (IHR): Dieter's ESAO Winter Schools and Beat's International Hypothermia Registry.

Accidental hypothermia could be listed as an 'orphan disease,' since mild hypothermia is common but has no severe medical consequences, whereas severe hypothermia is rare and life-threatening. In orde...

Hypothermia and targeted temperature management in cats and dogs.

To review current knowledge surrounding the effects, treatment, and prognosis of hypothermia in people, dogs, and cats, as well as the application of therapeutic hypothermia in clinical medicine.

Neonatal somatosensory evoked potentials persist during hypothermia.

Treatment with therapeutic hypothermia has challenged the use of amplitude-integrated electroencephalography in predicting outcomes after perinatal asphyxia. In this study, we assessed the feasibility...

Acute effect of whole-body vibration warm-up on footspeed quickness Effect of whole-body vibration warm-up on footspeed quickness.

The warm-up routine preceding a training or athletic event can affect the performance during that event. Whole-body vibration (WBV) can increase muscle performance, thus the inclusion of WBV to the wa...

Gastric Mucosal Petechial Hemorrhages (Wischnewsky Lesions), Hypothermia, and Diabetic Ketoacidosis.

For more than 100 years since their initial description, gastric mucosal petechial hemorrhages have been discovered at autopsy in cases where environmental hypothermia was determined to be the cause o...

Medical and Biotech [MESH] Definitions

Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries.

Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional.

Application of heat to correct hypothermia, accidental or induced.

A method of lowering core BODY TEMPERATURE by filling the STOMACH with chilled fluids.

A condition of the feet produced by prolonged exposure of the feet to water. Exposure for 48 hours or more to warm water causes tropical immersion foot or warm-water immersion foot common in Vietnam where troops were exposed to prolonged or repeated wading in paddy fields or streams. Trench foot results from prolonged exposure to cold, without actual freezing. It was common in trench warfare during World War I, when soldiers stood, sometimes for hours, in trenches with a few inches of cold water in them. (Andrews' Diseases of the Skin, 8th ed, p27)

More From BioPortfolio on "Preventing Inadvertent Hypothermia in Paediatric Neurosurgery in Malawi"

Quick Search

Searches Linking to this Trial