Infant Radiant Warmers

Abstract

Radiant warmers are frequently used in delivery rooms and neonatal care units when open access and external heat are simultaneously required.1 The sale of more than 13,000 units by U.S. manufacturers during the past ten years attests to the acceptance of these devices by pediatricians.2 However, some concern about the use of the warmers stems from potential hazards and the lack of information regarding possible effects of the devices. This concern was recently expressed by a panel of consultants to the Bureau of Medical Devices in the Food and Drug Administration (FDA) who recommended that the FDA obtain additional information to assist it in evaluating radiation warmer safety.3 If this recommendation is accepted by the FDA, current procedures require that additional information regarding the effects of radiant warmers on infants must be provided within a period of 30 months.4 Therefore, pediatricians should be aware of the issues involved. The most serious complication of radiant warmers is extreme hyperthermia, which may occur from improper use or from dislodgement of the sensor probe. Hyperthermia may result in death or permanent neurological damage (T. Peebles, personal communication). Insensible water loss increases markedly when infants are placed in the warm, dry, open environment under radiant warmers, and may increase by 50% to 200% over that observed among infants in incubators, depending on the maturity of the infant and the type of warmer.5 First-degree burns have been attributed to radiant warmer heating of plastic-lined disposable diapers which were placed next to the skin for urine collection.6