Effectiveness and safety of an inexpensive infant chemical warmer: a pilot study

Introduction. Hypothermia has been widely regarded as a major contributor to neonatal mortality and morbidity. Chemical warming packs used during delivery room resuscitation are associated with decreased rates of hypothermia. The ideal thermal mattress should be inexpensive, electricity-free, reusable, and safe for use in low-resource settings. In this pilot study, we describe the characteristics of a novel, inexpensive chemical warmer developed by the authors. Methods. The novel neonatal chemical warmer consists of two main components. The first component is the chemical warmer bag which is designed for single use, while the other is the container in which the chemical warmer is placed upon activation is reusable. A total of 5 chemical heaters were activated and tested. The goal was to determine whether the temperatures measured on the surface of the warmer were in the optimal range of the chemical heaters available so far. The temperature was measured every 5 minutes at 5 places (corners of the heater and in the middle of the heater), and the maximum measured temperature will be recorded. Temperatures were recorded every 5 minutes as long as the surface temperature measured above 35.9 ºC. Results. By the 5 minutes after activation two and at the 10th minute, all five chemical warmers achieved the desired surface temperature > 36.0 °C (range 38.4 – 40.4 °C.). The length in which the chemical warmer provided the temperatures in the desired range (36.0 – 42.0 °C) varied between 35 to 60 minutes, and we observed that this is highly dependent on starting surface temperatures. Regarding the safety of the surface temperatures produced, no recorded temperatures were above 42.0 °C. The maximum recorded temperature was 40.4 °C in the warmer, with the highest starting temperature in the 10th minute. Conclusion. The novel neonatal chemical warmer performed well when the starting surface temperatures were higher, with the best-performing one being the one with the highest starting temperature of 33.0 °C.