Technique

a. Place the infant in the supine position, with small

diaper on, in an open crib with overhead radiant

warmer turned off.

b. Insert a rectal temperature probe to 6 cm, as

described previously.

c. Connect the rectal temperature probe to the radiant

warmer temperature input.

Serial output from the radiant warmer provides

temperature data to the fan unit, via computer. The

software (Labview for Windows, National Instruments

Ltd, Austin, Texas) servo controls the power of the

fans within the fan unit.

d. Set the activation temperature of the fan manually,

well below the target core temperature (33.5°C),

and set the radiant warmer target temperature at

33.7°C. This allows the fan unit to consistently blow

at low power, while the warmer provides heat as

necessary to maintain the target rectal temperature.

e. After completing 72 hours of HT, rewarm by turning off the fan and progressively increasing the

target temperature on the radiant warmer to achieve

rewarming at a rate ≤0.5°C/h. Shield the head from

direct overhead heating (Fig. 45.21).

Fig. 45.10. Cooling with refrigerated gel packs placed under

the head and across the chest and trunk.

Fig. 45.9. Cooling with adjuncts. Gloves filled with cold water

are placed around the head, trunk, and legs to cool the infant, along

with rectal temperature monitoring.

Chapter 45 ■ Brain and Whole Body Cooling 333

Fig. 45.11. Infant cooled by a manually operated

Tecotherm TSmed 200N. Infant is inside a nonheated incubator. The temperature of the coolant in

the blanket is manually changed using the up and

down arrows beside the temperature display on the

cooling unit.

Pitfalls

Shivering can occur with higher fan speeds.

Cooling Using a Manual Control Cooling

Machine

Equipment

1. Tecotherm TSmed 200 N (TECCOM GmbH, Halle/

Salle, Germany) (Fig. 45.11)

2. Power cable

3. Cooling unit

4. Dual lumen connecting hoses

5. Cooling mattress (AquaPad mattress)

6. Coolant (Thermal fluid TECOmed)

7. Fill-up set

Technique (3)

1. Switch on the cooling unit after plugging in the power

cable.