2. Set the coolant temperature in the cooling unit to
3. Place the mattress inside an incubator with power
4. Undress the infant down to small diaper to maximize
skin contact with mattress for optimal heat exchange.
5. Secure a rectal temperature probe to 6 cm (see Fig.
6. Place the infant on the mattress inside the incubator.
7. When the rectal temperature reaches 35°C, increase
the set temperature in the cooling machine to 25°C.
8. To maintain the rectal temperature between 33°C and
34°C, set temperature in the cooling machine to
between 25°C and 30°C. This will vary with the body
weight and heat production of the infant.
9. To rewarm the infant at 0.5°C/h, increase the set fluid
temperature in the cooling machine by approximately
0.3°C/30 minutes. The core temperature will increase
with increases in the mattress temperature. This is very
difficult to get “right” and requires experience.
10.When core temperature of (36.5°C) has been reached, set
the incubator temperature to maintain normothermia.
12. Monitor rectal temperature for at least 24 hours after
achieving normothermia (36.5°C) (28).
1. Intermittent manual adjustment of coolant fluid temperature is required.
2. Overshoot of core temperature during induction of
3. Large swings in rectal temperature (29) (Fig. 45.11).
Cooling Using a Servocontrolled Cooling
The servocontrolled cooling systems cool and maintain the
core temperature by altering the temperature of the cooling
an incubator or preferably in an open bed.
1. The CritiCool (Fig. 45.12) (MTRE Advanced
Technologies Ltd, Yavne, Israel). Temperature
c. Cure wrap (MTRE Advanced Technologies Ltd,
334 Section IX ■ Miscellaneous Procedures
Green surface temperature sensor
Connecting tubes to temperature
Surface temperature sensor tip
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