Preventing Inadvertent Hypothermia in Paediatric Neurosurgery in Malawi
- Conditions
- Hypothermia
- Interventions
- Other: Warm AirOther: Hibler's
- Registration Number
- NCT02975817
- Lead Sponsor
- Oslo University Hospital
- Brief Summary
The investigators wish to undertake 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. The control group will be heated actively with the use of warm-air blankets. The aim of this study 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.
- Detailed Description
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.
The investigators wish to undertake a randomized controlled non-inferiority study in which two different modalities for preventing inadvertent intraoperative hypothermia are compared. The trial will be carried out 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. The goal is 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 given information about the study. If informed consent (and assent, where applicable) is obtained, participants 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. The trial will also examine a number of secondary end-points such as prevalence of shivering, conscious level, analgesia requirements, oxygenation and overall cost.
Upon completion of the study the investigators will seek to publish the 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 76
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Warm Air Warm Air Insert description from protocol Hibler's Hibler's Insert description from protocol
- Primary Outcome Measures
Name Time Method incidence of hypothermia from start of surgery till end of surgery incidence of core temperatures below 36,0 C
- Secondary Outcome Measures
Name Time Method incidence of postoperative shivering postoperative period, from start of stay at HDU (High Dependency Unit) till 5 hours into this stay incidence of shivering at arrival at and at the end of the fifth hour of stay in HDU
Oxygen requirements postoperative period, from start of stay at HDU (High Dependency Unit) till 5 hours into this stay requirement of supplemental oxygen (and mode of delivery) to maintain peripheral oxygen saturation at 95% or above
Degree of alertness postoperative period, from start of stay at HDU (High Dependency Unit) till 5 hours into this stay Degree of alertness (as judged using a simple 5 step scale) at arrival at and at the end of the fifth hour of stay in HDU
Proportion of surgery time spent normothermic from start of surgery till end of surgery proportion of surgery time spent at core temperature at or above 36,0 C
Trial Locations
- Locations (1)
Queen Elizabeth Central Hospital
🇲🇼Blantyre, Malawi