Keywords

gel pillow, intensive care, neonatal, patient simulation, temperature, thermoregulation

 

Authors

  1. Friddle, Kathryn MS, APRN, NNP-BC

ABSTRACT

PURPOSE: The gel-filled pillow is a device used to provide a soft surface to support and cradle an infant's head. Little is known about the thermal conductive properties of this device when used in an open crib. This simulation study evaluated the use of the Squishon 2 gel pillow in an open crib to determine the potential cooling effects on a mannequin infant.

 

SUBJECTS: This simulation study was conducted on a thermal mannequin.

 

DESIGN: A descriptive comparative repeated-measures design was employed.

 

METHODS: A thermal mannequin with the head placed on the gel pillow was used. The energy required to keep the mannequin head at 37[degrees]C in 4 conditions was measured. The 4 conditions were as follows: (1) lying in an open crib on a standard mattress (baseline), (2) lying on the gel pillow with the disposable cover from the manufacturer, (3) the head wearing a cap and lying on the gel pillow, and (4) the head without the hat lying on the gel pillow with an insulated cover over the pillow.

 

MAIN OUTCOME MEASURES: Univariate analysis of variance (ANOVA) revealed significant differences in energy required to maintain the mannequin head at 37[degrees]C among the 4 conditions (F3 = 283.23, P = .0001). The hat on head condition was found to decrease energy utilization by an average of 6.36 kcal/d when compared with the head on mattress condition (P = .0001). Extrapolation of energy to maintain mannequin head warmth into potential kilocalories utilized revealed that a potential increase in kilocalories needed to maintain thermoneutrality would be needed.

 

RESULTS: The most effective way of conserving heat was in the hat on the mannequin head while lying on a gel pillow condition. The use of a gel pillow without a hat or an insulated barrier caused an increase in energy requirements and kilocalorie usage in this mannequin model.

 

CONCLUSION: The results of this simulation study suggest that use of the gel pillow outside of a thermally controlled environment and in an open crib environment may increase energy use to maintain thermoneutrality. The Squishon 2 gel pillow conducts heat from the mannequin head and may increase kilocalories per day consumption in the preterm infant. Furthermore, the results of the study support previous findings that a hat helps conserve energy.