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Peer-reviewedCC BY-NC-ND 4.0BMC Pediatrics

A practical strategy to reduce perioperative hypothermia in NICU patients

  • Anna Chizuko Hoover1
  • Anne Harrington2
  • Francine Yudkowitz3
  • Courtney Juliano4
  • Shanna Spain4
  • Brian Arrinza Coakley2,5
5 affiliations
  1. 1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
  2. 2Department of Surgery, Division of Pediatric General Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
  3. 3Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
  4. 4Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
  5. 5Department of Surgery, Division of Pediatric Surgery, Seattle Children’s Hospital, Seattle, WA 98105 USA
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Abstract

Background: Neonates and infants undergoing surgery are at particularly high risk of developing hypothermia, as defined by a temperature less than 36 °C. Perioperatively, they are vulnerable to temperature dysregulation during transport to and from the operating room as well as exposure during the surgery itself. Additionally, their unique body composition makes heat conservation and thermoregulation challenging as compared to adults. Our aim was to reduce the rate of perioperative hypothermia in neonates and infants hospitalized in the neonatal intensive care unit (NICU) who underwent a surgical procedure.

Methods: Our team utilized the Model for Improvement with sequential Plan-Do-Study-Act (PDSA) cycles to implement interventions aimed at reducing perioperative hypothermia rates. This included development of a hypothermia prevention bundle, creation of checklists and education tools for providers, regular case review and supplemental bundle interventions for the highest risk patients.

Results: Perioperative hypothermia rates decreased significantly to less than 5% after study interventions compared to a baseline rate of 16.9%. There was no change in the pre-specified balancing measure of postoperative hyperthermia.

Conclusion: This quality improvement initiative, which prioritized implementation of a prevention bundle, addition of specialized bundle elements for high-risk cohorts, and regular case review, resulted in a decrease in perioperative hypothermia rates for NICU patients undergoing surgical procedures.

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Cite

BibTeXRIS
BibTeX
@article{hoover2026practical,
  title = {{A practical strategy to reduce perioperative hypothermia in NICU patients}},
  author = {Anna Chizuko Hoover and Anne Harrington and Francine Yudkowitz and Courtney Juliano and Shanna Spain and Brian Arrinza Coakley},
  journal = {BMC Pediatrics},
  year = {2026},
  month = jul,
  doi = {10.1186/s12887-026-07290-8},
  url = {https://doi.org/10.1186/s12887-026-07290-8},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - A practical strategy to reduce perioperative hypothermia in NICU patients
AU  - Anna Chizuko Hoover
AU  - Anne Harrington
AU  - Francine Yudkowitz
AU  - Courtney Juliano
AU  - Shanna Spain
AU  - Brian Arrinza Coakley
PY  - 2026
DA  - 2026/07/25
JO  - BMC Pediatrics
DO  - 10.1186/s12887-026-07290-8
UR  - https://doi.org/10.1186/s12887-026-07290-8
AB  - Background: Neonates and infants undergoing surgery are at particularly high risk of developing hypothermia, as defined by a temperature less than 36 °C. Perioperatively, they are vulnerable to temperature dysregulation during transport to and from the operating room as well as exposure during the surgery itself. Additionally, their unique body composition makes heat conservation and thermoregulation challenging as compared to adults. Our aim was to reduce the rate of perioperative hypothermia in neonates and infants hospitalized in the neonatal intensive care unit (NICU) who underwent a surgical procedure.  Methods: Our team utilized the Model for Improvement with sequential Plan-Do-Study-Act (PDSA) cycles to implement interventions aimed at reducing perioperative hypothermia rates. This included development of a hypothermia prevention bundle, creation of checklists and education tools for providers, regular case review and supplemental bundle interventions for the highest risk patients.  Results: Perioperative hypothermia rates decreased significantly to less than 5% after study interventions compared to a baseline rate of 16.9%. There was no change in the pre-specified balancing measure of postoperative hyperthermia.  Conclusion: This quality improvement initiative, which prioritized implementation of a prevention bundle, addition of specialized bundle elements for high-risk cohorts, and regular case review, resulted in a decrease in perioperative hypothermia rates for NICU patients undergoing surgical procedures.
SN  - 1471-2431
ER  -