Effect of temperature maintenance by forced-air warming blankets of different temperatures on changes in inflammatory factors in children undergoing congenital hip dislocation surgery

BACKGROUND: Hypothermia is associated with many adverse clinical outcomes in pediatric patients, and thus, it is important to find an effective and safe method for preventing peri-operative hypothermia and its associated adverse outcomes in pediatric patients. This study aimed to investigate the effect of forced-air warming blankets with different temperatures on changes in the transforming growth factor-β (TGF-β), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-10 levels in children undergoing surgical treatment for developmental displacement of the hip (DDH). METHODS: The study included 123 children undergoing surgery for DDH under general anesthesia. The patients were randomly assigned to three groups, using a random number table: the 32, 38, and 43°C groups according to the temperature setting of the forced-air warming blankets. For each patient, body temperature was recorded immediately after anesthesia induction and intubation (T(0)), at initial incision (T(1)), at 1 h after incision (T(2)), at 2 h after incision (T(3)), at the end of surgery (T(4)), immediately upon return to the ward after surgery (T(5)), and then at 12 h (T(6)), 24 h (T(7)), 36 h (T(8)), and 48 h (T(9)) after the surgery. The serum levels of TGF-β, TNF-α, IL-1β, and IL-10 were measured at T(0) and T(4) for all groups. RESULTS: The number of patients with fever in the 38°C group was significantly less than those in the 32 and 43°C groups (χ(2) = 6.630, P = 0.036). At T(0), the body temperatures in the 38 and 43°C groups were significantly higher than that in the 32°C group (F = 17.992, P < 0.001). At T(2), the body temperature was significantly higher in the 43°C group than those in the 32 and 38°C groups (F = 12.776, P < 0.001). Moreover, at T(4), the serum levels of TGF-β (F = 3286.548, P < 0.001) and IL-10 (F = 4628.983, P < 0.001) were significantly increased in the 38°C group, and the serum levels of TNF-α (F = 911.415, P < 0.001) and IL-1β (F = 322.191, P < 0.001) were significantly decreased in the 38°C group, compared with the levels in the 32 and 43°C groups. CONCLUSION: Force-air warming blankets set at 38°C maintained stable body temperature with less adverse outcome and effectively inhibited the inflammatory response in pediatric patients undergoing surgery for DDH. CLINICAL TRIAL REGISTRATION: ChiCTR1800014820; http://www.chictr.org.cn/showproj.aspx?proj=25240.