The effect of administered crystalloid fluid temperature on aural temperature of moderately and severely injured children.

OBJECTIVE

Warm intravenous fluid (W-IVF) administration is the standard of care to prevent hypothermia in injured adults. It is argued that such administration may not be helpful for treating injured children, because children often do not require as much intravenous fluid (i.v.f.) as adults. The purpose of this study was to compare the effects of W-i.v.f. to room temperature intravenous fluid (RT-i.v.f.) administration on aural temperature (Ta) in injured children during the first hour of trauma resuscitation.

DESIGN

A randomized, controlled repeated-measures trial.

SETTING

Emergency department, intensive care unit, and diagnostic areas in a level I pediatric trauma center.

SAMPLE: Thirty moderately or severely injured children, ranging in age from 2 to 17 years (mean age = 8.9 years; SD = 4.4).

METHODS

Eligible children were randomly assigned to receive either W-i.v.f. or RT-i.v.f. on ED arrival. Warmed IVF was administered with the Hotline fluid warmer (SIMS Level 1, Rockland, Mass). Aural temperatures were measured on arrival and every 10 minutes for 1 hour with a Core-Check Tympanic Thermometer (IVAC Medical Systems, San Diego, Calif). The level of significance for hypothesis testing was set at 0.05 (two-tailed).

RESULTS

Groups were comparable in age, gender, weight, amount of infused i.v.f., Revised Trauma Score, room temperature, and baseline Ta. On average, Ta for the W-i.v.f. group increased by 0.25 degree C from baseline to final Ta, whereas Ta for the RT-i.v.f. group decreased by 0.32 degree C from baseline to final Ta. Repeated-measures analysis of covariance, treating baseline Ta as a covariate, demonstrated that Ta response profiles were similar (p = 0.06).

CONCLUSIONS

When comparing the changes between baseline and final Ta for the W-i.v.f. and RT-i.v.f. groups, the standardized difference in temperature change was 0.62. Although results of the repeated measures analysis of covariance were not statistically significant, the standardized difference in temperature changes was large enough to warrant administration of W-i.v.f., even at slow flow rates, to prevent hypothermia in injured children.