Heat-related risk at Paris 2024: a proposal for classification and review of International Federations policies.

Several International Federations (IFs) employ specific policies to protect athletes' health from the danger of heat. Most policies rely on the measurement of thermal indices such as the Wet Bulb Globe Temperature (WBGT) to estimate the risk of heat-related illness. This review summarises the policies implemented by the 32 IFs of the 45 sports included in the Paris 2024 Olympic Games. It provides details into the venue type, measured parameters, used thermal indices, measurement procedures, mitigation strategies and specifies whether the policy is a recommendation or a requirement. Additionally, a categorisation of sports' heat stress risk is proposed. Among the 15 sports identified as high, very high or extreme risk, one did not have a heat policy, three did not specify any parameter measurement, one relied on water temperature, two on air temperature and relative humidity, seven on WBGT (six measured on-site and one estimated) and one on the Heat Stress Index. However, indices currently used in sports have been developed for soldiers or workers and may not adequately reflect the thermal strain endured by athletes. Notably, they do not account for the athletes' high metabolic heat production and their level of acclimation. It is, therefore, worthwhile listing the relevance of the thermal indices used by IFs to quantify the risk of heat stress, and in the near future, develop an index adapted to the specific needs of athletes.

High-density thermal sensitivity maps of the body of people with multiple sclerosis: Implications for inclusive personal comfort systems.

Inclusive thermal comfort solutions should accommodate the need of clinical groups such as people with Multiple Sclerosis (pwMS), who experience abnormal thermal sensitivity. The aim of this study was to develop high-density body maps of temperature sensitivity in pwMS to inform the design of patient-centred personal comfort systems. Fourteen pwMS (6 M/8 F; 48.6 ± 10.0 y) and 13 healthy individuals (CTR; 5 M/8 F; 47.8 ± 10.4) underwent a quantitative sensory test in a thermoneutral environment, during which they rated their local thermal sensations arising from the application of warm (39°C) and cold (27°C) stimuli to 115 bilateral body sites across the face, torso, upper and lower limbs. We used a z-transformation to create maps of hypo- and hyper-sensitivity for each individual MS participant using normative CTR data. We found that 50% of pwMS (N = 7/14) presented a loss of cold sensitivity over the upper limb, and a loss of warm sensitivity over the feet. Furthermore, 36% of pwMS (N = 5) presented warm hyper-sensitivity over the upper limb. Finally, cold sensitivity loss and warm sensitivity gain were more evenly distributed and affected a greater proportion of skin sites in MS (i.e. cold hypo-sensitivity = 44% of tested sites; warm hyper-sensitivity = 14%) than warm sensitivity loss (i.e. 10%), which was more focused on sites such as the feet. Our findings highlight the need to consider "thermosensory corrective power" when designing personal comfort systems, to accommodate either thermosensory loss or gain in pwMS. Our approach to clinical body mapping may support this process and help meeting the unique thermal needs of vulnerable individuals.

The Effect of Brief Warming during Induction of General Anesthesia and Warmed Intravenous Fluid on Intraoperative Hypothermia in Patients Undergoing Urologic Surgery.

Background and Objectives: Transurethral urologic surgeries frequently lead to hypothermia due to bladder irrigation. Prewarming in the preoperative holding area can reduce the risk of hypothermia but disrupts surgical workflow, preventing it from being of practical use. This study explored whether early intraoperative warming during induction of anesthesia, known as peri-induction warming, using a forced-air warming device combined with warmed intravenous fluid could prevent intraoperative hypothermia. Materials and Methods: Fifty patients scheduled for transurethral resection of the bladder (TURB) or prostate (TURP) were enrolled and were randomly allocated to either the peri-induction warming or control group. The peri-induction warming group underwent whole-body warming during anesthesia induction using a forced-air warming device and was administered warmed intravenous fluid during surgery. In contrast, the control group was covered with a cotton blanket during anesthesia induction and received room-temperature intravenous fluid during surgery. Core temperature was measured upon entrance to the operating room (T0), immediately after induction of anesthesia (T1), and in 10 min intervals until the end of the operation (Tend). The incidence of intraoperative hypothermia, change in core temperature (T0-Tend), core temperature drop rate (T0-Tend/[duration of anesthesia]), postoperative shivering, and postoperative thermal comfort were assessed. Results: The incidence of intraoperative hypothermia did not differ significantly between the two groups. However, the peri-induction warming group exhibited significantly less change in core temperature (0.61 ± 0.3 °C vs. 0.93 ± 0.4 °C, p = 0.002) and a slower core temperature drop rate (0.009 ± 0.005 °C/min vs. 0.013 ± 0.004 °C/min, p = 0.013) than the control group. The peri-induction warming group also reported higher thermal comfort scores (p = 0.041) and less need for postoperative warming (p = 0.034) compared to the control group. Conclusions: Brief peri-induction warming combined with warmed intravenous fluid was insufficient to prevent intraoperative hypothermia in patients undergoing urologic surgery. However, it improved patient thermal comfort and mitigated the absolute amount and rate of temperature drop.

Beyond day and night: The importance of ultradian rhythms in mouse physiology.

Our circadian world shapes much of metabolic physiology. In mice ∼40% of the light and ∼80% of the dark phase time is characterized by bouts of increased energy expenditure (EE). These ultradian bouts have a higher body temperature (Tb) and thermal conductance and contain virtually all of the physical activity and awake time. Bout status is a better classifier of mouse physiology than photoperiod, with ultradian bouts superimposed on top of the circadian light/dark cycle. We suggest that the primary driver of ultradian bouts is a brain-initiated transition to a higher defended Tb of the active/awake state. Increased energy expenditure from brown adipose tissue, physical activity, and cardiac work combine to raise Tb from the lower defended Tb of the resting/sleeping state. Thus, unlike humans, much of mouse metabolic physiology is episodic with large ultradian increases in EE and Tb that correlate with the active/awake state and are poorly aligned with circadian cycling.

Female thermal sensitivity and behaviour across the lifespan: A unique journey.

Women are a group of individuals that undergo unique anatomical, physiological and hormonal changes across the lifespan. For example, consider the impact of the menstrual cycle, pregnancy and menopause, all of which are accompanied by both short- and long-term effects on female body morphology (e.g., changes in breast size) and temperature regulation, heat tolerance, thermal sensitivity and comfort. However, empirical evidence on how skin thermal and wetness sensitivity might change across the lifespan of women, and the implications that this has for female-specific thermal behaviours, continues to be lacking. This paper is based on a symposium presentation given at Physiology 2023 in Harrogate, UK. It aims to review new evidence on anatomical and physiological mechanisms underpinning differences in skin thermal and wetness sensitivity amongst women varying in breast size and age, in addition to their role in driving female thermal behaviours. It is hoped that this brief overview will stimulate the development of testable hypotheses to increase our understanding of the behavioural thermal physiology of women across the lifespan and at a time of climate change.

Bundle para regulação da temperatura corporal de recém-nascidos maiores de 34 semanas: construção e validação / Bundle for regulating the body temperature of newborns over 34 weeks: Construction and validation / Paquete para regular la temperatura corporal de recién nacidos de más de 34 semanas: construcción y validación

Objetivo: Descrever o processo de construção e validação de um bundle para promoção da regulação da temperatura corporal de recém-nascidos maiores de 34 semanas. Métodos: Pesquisa metodológica executada em três etapas: revisão de escopo, construção da primeira versão do bundle e validação de conteúdo realizada por 15 experts, sendo nove enfermeiros e seis médicos, selecionados conforme critérios adaptados de referencial na área. O índice de validade de conteúdo acima de 0,80 foi considerado aceitável para a concordância entre os experts sobre cada cuidado. Foram necessárias duas rodadas de avaliação para a confecção da versão final. Resultados: O bundle foi estruturado em cuidados: na sala de parto, no transporte e no alojamento conjunto, com total de 15 itens, todos com concordância acima de 0,90 após a segunda rodada de avaliação. Conclusão: O bundle elaborado foi considerado válido quanto ao conteúdo e estabelece cuidados baseados em evidências científicas de maneira padronizada e segura para a equipe de assistência ao parto.

Objective: Describe the process of building and validating a bundle to promote body temperature regulation in newborns over 34 weeks of age. Methods: This methodological research was carried out in three stages: a scoping review, construction of the first version of the bundle, and content validation by 15 experts, nine nurses and six physicians, selected according to criteria adapted from references in the field. A content validity index above 0.80 was considered acceptable for the agreement among the experts on each type of care. Two rounds of evaluation were required to produce the final version. Results: The bundle was structured into care in the delivery room, during transportation, and in the rooming- in unit, with a total of 15 items, all with agreement above 0.90 after the second round of evaluation. Conclusion: The bundle developed was considered valid in terms of content and establishes care based on scientific evidence in a standardized and safe way for the childbirth care team.

Objetivo: Describir el proceso de creación y validación de un paquete para promover la regulación de la temperatura corporal en recién nacidos de más de 34 semanas de edad. Métodos: Investigación metodológica realizada en tres etapas: una revisión del alcance, la construcción de la primera versión del paquete y la validación del contenido llevada a cabo por 15 expertos, nueve enfermeras y seis médicos, seleccionados según criterios adaptados a partir de referencias en la materia. Se consideró aceptable un índice de validez de contenido superior a 0,80 para el acuerdo entre los expertos sobre cada tipo de atención. Fueron necesarias dos rondas de evaluación para elaborar la versión final. Resultados: El paquete se estructuró en cuidados: en la sala de partos, durante el transporte y en la unidad de alojamiento, con un total de 15 ítems, todos ellos con una concordancia superior a 0,90 tras la segunda ronda de evaluación. Conclusión: El paquete se consideró válido en cuanto a su contenido y establece una atención basada en pruebas científicas de forma estandarizada y segura para el equipo de atención al parto.

Myotendinous Thermoregulation in National Level Sprinters after a Unilateral Fatigue Acute Bout-A Descriptive Study.

In the last decade there has been a growing interest in infrared thermography in the field of sports medicine in order to elucidate the mechanisms of thermoregulation. The aim of this study was to describe bilateral variations in skin temperature of the anterior thigh and patellar tendon in healthy athletes and to provide a model of baseline tendon and muscle thermoregulation in healthy sprinters following a unilateral isokinetic fatigue protocol. Fifteen healthy national-level sprinters (eleven men and four women), with at least 3 years of athletic training experience of 10-12 h/week and competing in national-level competitions, underwent unilateral isokinetic force testing and electrostimulation in which their body temperature was measured before, during, and after the protocol using an infrared thermographic camera. ANOVA detected a significant difference in the time × side interaction for patellar temperature changes (p ≤ 0.001) and a significant difference in the time/side interaction for quadriceps temperature changes (p ≤ 0.001). The thermal challenge produces homogeneous changes evident in quadriceps areas, but not homogeneous in tendon areas. These data show that metabolic and blood flow changes may depend on the physical and mechanical properties of each tissue. Future research could be conducted to evaluate the predictive value of neuromuscular fatigue in the patellar tendon and quadriceps after exercise in order to optimize post-exercise recovery strategies.

Estratégias de termorregulação em recém-nascidos prematuros: uma revisão de escopo / Thermoregulation strategies in premature newborns: a scoping review / Estrategias de termorregulación en recién nacidos prematuros: una revisión de alcance

Objetivo: mapear as estratégias para o controle e regulação da temperatura corporal em recém-nascidos prematuros. Método: revisão de escopo sobre termorregulação do prematuro, orientada pelas recomendações do Instituto Joanna Briggs, desenvolvida em oito bases de informações eletrônica. A busca, síntese e análise dos resultados ocorreu em dezembro de 2022. Resultados: compuseram a revisão 15 estudos que foram agrupados em duas categorias: Fontes de calor e Uso de pacotes de medidas/bundle. Como estratégias para a manutenção da temperatura corporal do prematuro, destacam-se: temperatura adequada materna e do ambiente; envoltório plástico; touca dupla; panos aquecidos; aquecimento do ar no suporte respiratório; contato pele a pele; berços aquecidos e incubadoras. Evidenciou-se que os recursos conjugados foram mais efetivos do que quando usados isoladamente. Conclusão: os resultados da revisão de escopo apontaram para estratégias que podem ser utilizadas para mitigar os riscos de hipotermia em recém-nascidos prematuros(AU)

Objective: to map strategies for controlling and regulating body temperature in premature newborns. Method: scope review on premature thermoregulation, guided by the recommendations of the Joanna Briggs Institute, developed in eight electronic databases. The search, synthesis and analysis of the results took place in December 2022. Results: the review was made up of 15 studies, which were grouped into two categories: Heat sources and use of measurement packages/bundle. As strategies for maintaining the body temperature of preterm infants, the following stand out: adequate maternal and environmental temperature; plastic wrap; double bonnet; heated cloths; air heating in respiratory support; skin-to-skin contact; heated cribs and incubators. It was evident that the combined resources were more effective than when used separately. Conclusion: the scoping review results pointed to strategies that can be used to mitigate the risks of hypothermia in premature newborns(AU)

Objetivo: mapear estrategias para el control y regulación de la temperatura corporal en recién nacidos prematuros. Método: revisión de alcance sobre la termorregulación prematura, siguiendo las recomendaciones del Instituto Joanna Briggs, desarrollada en ocho bases de datos electrónicas. La búsqueda, la síntesis y el análisis de los resultados se llevaron a cabo en diciembre de 2022. Resultados: la revisión fue conformada de 15 estudios, agrupados en dos categorías: fuentes de calor y uso de paquetes de medidas/bundle. Como estrategias para mantener la temperatura corporal del prematuro se destacan: temperatura adecuada materna y ambiental; envoltura de plástico; gorro doble; paños tibios; calentamiento del aire en soporte respiratorio; contacto piel a piel; cunas calefaccionadas e incubadoras. Se evidenció que los recursos combinados fueron más efectivos que si usados de forma individual. Conclusión: los resultados de la revisión de alcance señalaron estrategias que pueden usarse para mitigar los riesgos de hipotermia en recién nacidos prematuros(AU)

Head cooling wrap could suppress the elevation of core temperature after cardiac surgery during forced-air warming in a pediatric intensive care unit: a randomized clinical trial.

PURPOSE: The main aim of the current trial was to explore our hypothesis that cooling head wraps lower the core temperature more effectively than ice packs on the head during forced-air warming after pediatric cardiac surgeries. METHODS: This study was a single-center Randomized Controlled Trial. Participants were children with a weight ≤ 10 kg and hyperthermia during forced-air warming after cardiac surgeries. When the core temperature reached 37.5 °C, ice packs on the head (group C) or a cooling head wrap (group H) were used as cooling devices to decrease the core temperature. The primary outcome was the core temperature. The secondary outcomes were the foot surface temperature and heart rate. We measured all outcomes every 30 min for 240 min after the patient developed hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and also the Bonferroni test as a post hoc analysis. RESULTS: Twenty patients were randomly assigned to groups C and H. The series of core temperatures in group H were significantly lower than those in group C (p < 0.0001), and post hoc analysis showed that there was no significant difference in core temperatures at T0 between the two groups and statistically significant differences in all core temperatures at T30-240 between the two groups. There was no difference between the two groups' surface temperatures and heart rates. CONCLUSIONS: Compared to ice packs on the head, head cooling wraps more effectively suppress core temperature elevation during forced-air warming after pediatric cardiac surgery.

Implications of the Onset of Sweating on the Sweat Lactate Threshold.

The relationship between the onset of sweating (OS) and sweat lactate threshold (sLT) assessed using a novel sweat lactate sensor remains unclear. We aimed to investigate the implications of the OS on the sLT. Forty healthy men performed an incremental cycling test. We monitored the sweat lactate, blood lactate, and local sweating rates to determine the sLT, blood LT (bLT), and OS. We defined participants with the OS during the warm-up just before the incremental test as the early perspiration (EP) group and the others as the regular perspiration (RP) group. Pearson's correlation coefficient analysis revealed that the OS was poorly correlated with the sLT, particularly in the EP group (EP group, r = 0.12; RP group, r = 0.56). Conversely, even in the EP group, the sLT was strongly correlated with the bLT (r = 0.74); this was also the case in the RP group (r = 0.61). Bland-Altman plots showed no bias between the mean sLT and bLT (mean difference: 19.3 s). Finally, in five cases with a later OS than bLT, the sLT tended to deviate from the bLT (mean difference, 106.8 s). The sLT is a noninvasive and continuous alternative to the bLT, independent of an early OS, although a late OS may negatively affect the sLT.

Self-reported effects of warm seasonal temperatures in persons with spinal cord injury.

OBJECTIVE: Spinal cord injury (SCI) interrupts motor, sensory, and autonomic pathways, impairing mobility and increasing heat storage during warm seasonal temperatures due to compromised autonomic control of vasodilation and sweating and recognition of body temperature. Thus, persons with SCI are more vulnerable to hyperthermia and its adverse effects. However, information regarding how persons with SCI perceive warmer seasons and whether thermal discomfort during warmer seasons restricts routine activities remains anecdotal. DESIGN: Cross-sectional, self-report surveys. SETTING: VA Medical Center and Kessler Institute for Rehabilitation. PARTICIPANTS: Three groups of 50 participants each: tetraplegia, paraplegia, and matched non-SCI controls. OUTCOME MEASURES: Tetraplegia, paraplegia, and control groups responded "yes" or "no" when asked whether warm seasonal temperatures adversely affected comfort or participation in routine activities. RESULTS: The percentage of responses differed among tetraplegia, paraplegia, and control groups when asked if they required ≥20 min to cool down once overheated (44 vs. 20 vs. 12%; X2 = 14.7, P < 0.001), whether heat-related discomfort limited their ability to go outside (62 vs. 34 vs. 32%; X2 = 11.5, P = 0.003), if they needed to use a water-mister because of the heat (70 vs. 44 vs. 42%; X2 = 9.8, P = 0.008), and if heat-related discomfort limited participation in social activities (40 vs. 20 vs. 16%; X2 = 8.7, P = 0.01). CONCLUSION: Warmer seasonal temperatures had a greater negative impact on reported comfort and daily activities of persons with SCI than non-SCI controls. Those with tetraplegia were most adversely affected. Our findings warrant increasing awareness and identifying interventions to address the vulnerability of persons with SCI to hyperthermia.

Body temperatures, thermal comfort, and neuropsychological responses to air temperatures ranging between 12°C and 39°C in people with Multiple Sclerosis.

The negative effects of thermal stress on Multiple Sclerosis (MS)' symptoms have long been known. However, the underlying mechanisms of MS heat and cold intolerance remain unclear. The aim of this study was to evaluate body temperatures, thermal comfort, and neuropsychological responses to air temperatures between 12 and 39 °C in people with MS compared to healthy controls (CTR). Twelve MS (5 males/7 females; age: 48.3 ± 10.8 years; EDSS range: 1-7) and 11 CTR participants (4 males /7 females; age: 47.5 ± 11.3 years) underwent two 50-min trials in a climatic chamber. Air temperature was ramped from 24 °C to either 39 °C (HEAT) or 12 °C (COLD) and we continuously monitored participants' mean skin (Tsk) and rectal temperatures (Trec), heart rate and mean arterial pressure. We recorded participants' self-reported thermal sensation and comfort, mental and physical fatigue, and we assessed their cognitive performance (information processing). Changes in mean Tsk and Trec did not differ between MS and CTR neither during HEAT nor COLD. However, at the end of the HEAT trial, 83% of MS participants and 36% of CTR participants reported being "uncomfortable". Furthermore, self-reports of mental and physical fatigue increased significantly in MS but not CTR (p < 0.05), during both HEAT and COLD. Information processing was lower in MS vs. CTR (p < 0.05); yet this cognitive impairment was not exacerbated by HEAT nor COLD (p > 0.05). Our findings indicate that neuropsychological factors (i.e. discomfort and fatigue) could contribute to MS heat and cold intolerance in the absence of deficits in the control of body temperature.

Thermoregulatory, Cardiovascular and Perceptual Responses of Spectators of a Simulated Football Match in Hot and Humid Environmental Conditions.

Major sporting events are often scheduled in thermally challenging environments. The heat stress may impact athletes but also spectators. We examined the thermal, cardiovascular, and perceptual responses of spectators watching a football match in a simulated hot and humid environment. A total of 48 participants (43 ± 9 years; n = 27 participants <50 years and n = 21 participants ≥50 years, n = 21) watched a 90 min football match in addition to a 15 min baseline and 15 min halftime break, seated in an environmental chamber (Tair = 31.9 ± 0.4 °C; RH = 76 ± 4%). Gastrointestinal temperature (Tgi), skin temperature (Tskin), and heart rate (HR) were measured continuously throughout the match. Mean arterial pressure (MAP) and perceptual parameters (i.e., thermal sensation and thermal comfort) were scored every 15 min. Tri (37.3 ± 0.4 °C to 37.4 ± 0.3 °C, p = 0.11), HR (76 ± 15 bpm to 77 ± 14 bpm, p = 0.96) and MAP (97 ± 10 mm Hg to 97 ± 10 mm Hg, p = 0.67) did not change throughout the match. In contrast, an increase in Tskin (32.9 ± 0.8 °C to 35.4 ± 0.3 °C, p < 0.001) was found. Further, 81% of participants reported thermal discomfort and 87% a (slightly) warm thermal sensation at the end of the match. Moreover, the thermal or cardiovascular responses were not affected by age (all p-values > 0.05). Heat stress induced by watching a football match in simulated hot and humid conditions does not result in substantial thermal or cardiovascular strain, whereas a significant perceptual strain was observed.

The Association Between Induction Rate and Neurologic Outcome in Patients Undergoing Targeted Temperature Management at 33°C.

To determine the association between the induction rate and 6-month neurologic outcomes in out-of-hospital cardiac arrest (OHCA) survivors who underwent targeted temperature management (TTM). This retrospective observational study analyzed data prospectively collected from adult comatose OHCA survivors treated with TTM at the Chonnam National University Hospital in Gwangju, Korea, between October 2015 and December 2020. We measured the core body temperature (BT) through an esophageal probe and recorded it every 5 minutes throughout TTM. Induction time was defined as the elapsed time between the initiation of TTM and the achievement of target BT of 33°C. We calculated the induction rate as the change of BT divided by induction time. The primary outcome was a poor 6-month neurologic outcome, defined as cerebral performance category 3-5. Of the OHCA survivors, 218 patients were included, and 137 (62.8%) patients had a poor neurologic outcome. Patients with a poor neurologic outcome had lower BT at the initiation of TTM, shorter induction time, and higher induction rate than those with good neurologic outcomes. After adjusting for confounders, induction time (odds ratio [OR] 0.995; 95% confidence interval [CI], 0.992-0.999) and induction rate (OR 2.362; 95% CI, 1.178-4.734) were independently associated with poor neurologic outcome. BT at TTM initiation was not associated with a poor neurologic outcome. Induction rate was independently associated with a poor neurologic outcome in OHCA survivors who underwent TTM at 33°C.

A complexidade do cuidado para o controle térmico do recém-nascido prematuro / The complexity of care for the thermal control of the premature infant

RESUMO Objetivo compreender a percepção dos enfermeiros sobre a complexidade do cuidado para o controle térmico do recém-nascido prematuro. Métodos estudo qualitativo realizado com 13 enfermeiros de maternidade pública, por meio de entrevista virtual, com roteiro semiestruturado, submetido à Análise de Conteúdo e interpretado pelo suporte teórico do modelo do sistema adaptativo complexo de cuidado. Resultados os fatores presentes nos cuidados dos enfermeiros no controle térmico do recém-nascido prematuro estão relacionados à complexidade permeada por fatores ambientais como a temperatura da unidade e a distribuição das correntes de ar condicionado; fatores institucionais como a disponibilização e uso correto de tecnologias, e aos relacionados com o profissional, como atuação, treinamento e capacitação. Conclusão adequar a temperatura da unidade; melhor distribuição das correntes do ar condicionado; a disponibilidade de tecnologias; política de educação continuada no serviço; treinamentos de manuseio dos equipamentos; fiscalização e exigência de manutenção preventiva e corretiva dos aparelhos podem influenciar a redução dos eventos de instabilidade térmica do recém-nascido prematuro. Contribuições para a prática estimular a qualificação profissional, planejamento de ações intersetoriais para a estruturação tecnológica e manutenção preventiva das unidades, sistematização da assistência ao recém-nascido prematuro no controle térmico minimizando o risco de morbimortalidade neonatal por instabilidade térmica.

ABSTRACT Objective to understand the perception of nurses about the complexity of care for thermal control of the premature infant. Methods qualitative study conducted with 13 nurses from a public maternity hospital, through virtual interviews, with semi-structured script, submitted to Content Analysis and interpreted by the theoretical support of the complex adaptive care system model. Results the factors present in nurses' care in thermal control of premature infants are related to the complexity permeated by environmental factors such as the temperature of the unit and distribution of air conditioning currents; institutional factors such as the availability and correct use of technologies, and those related to the professional, such as performance, training, and qualification. Conclusion adjusting the temperature of the unit; better distribution of the air conditioning currents; availability of technologies; a policy of continued education in the service; training in handling the equipment; supervision and requirement for preventive and corrective maintenance of the devices can influence the reduction of thermal instability events in premature infants. Contributions to practice stimulating professional qualification, planning of intersectoral actions for technological structuring and preventive maintenance of the units, systematization of assistance to premature infants in thermal control minimizing risk of neonatal morbimortality due to thermal instability.

Cuidado de la temperatura en personas sometidas a procedimientos quirúrgicos electivos en una institución de salud / Temperature care in persons undergo-ing elective surgical procedures in a health institution

Objetivo: Analizar la adherencia a las actividades para el control de la termorregulación en procedimientos quirúrgicos por parte de técnicos y profesionales de cirugía para el año 2021 en una institución de salud de tercer nivel en la ciudad de Medellín, Colombia. Metodología: Investigación descriptiva transversal. Se revisaron registros clínicos de pacientes sometidos a cirugía electiva mayor a una hora, también se realizó encuesta autoaplicada a personal que labora en el área quirúrgica, indagando por variables demográficas, del servicio y de adherencia al protocolo de termorregulación. Resultados: Se evidencia baja adherencia a la toma de temperatura. En el servicio de recuperación hay mejor adherencia por medio del calentamiento activo. Conclusión: La temperatura es un signo vital al que no se le da la importancia suficiente, constituyéndose así como una constante vital olvidada.(AU)

Objective: To analyze adherence to activities for the control of thermoregulation in surgical procedures by surgical technicians and professionals for the year 2021, in a tertiary health institution in the city of Medellín, Colombia. Methods: Cross-sectional descriptive research. Clinical records of patients undergoing elective surgery greater than one hour were reviewed, a self-applied survey was also carried out on personnel working in the surgical area, inquiring for demographic variables, service and adherence to the thermoregulation protocol. Results: Low adherence to temperature measurement is evident. In the recovery service there are better adherence through active heating. Conclusions: Temperature is a vital sign that is not given enough importance, thus becoming a forgotten vital sign.Objective: To analyze adherence to activities for the control of thermoregulation in surgical procedures by surgical technicians and professionals for the year 2021, in a tertiary health institution in the city of Medellín, Colombia. Methods: Cross-sectional descriptive research. Clinical records of patients undergoing elective surgery greater than one hour were reviewed, a self-applied survey was also carried out on personnel working in the surgical area, inquiring for demographic variables, service and adherence to the thermoregulation protocol. Results: Low adherence to temperature measurement is evident. In the recovery service there are better adherence through active heating. Conclusions: Temperature is a vital sign that is not given enough importance, thus becoming a forgotten vital sign.(AU)