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Hypothermia is a well documented problem for surgical patients and is historically addressed by the use of a variety of warming aids and devices applied to the patient before, during, and after surgery. Their effectiveness is limited in many surgeries by practical constraints of surgical access, and hypothermia remains a significant concern. Increasing the temperature of the operating room has been proposed as an alternative solution. However, operating room temperatures must be cool enough to limit thermal stress on the surgical team despite the heat transport barriers imposed by protective sterile garments. Space technology in the form of the liquid cooling garment worn by EVA astronauts answers this need. Hamilton Sundstrand Space Systems International (HSSSI) has been working with Hartford Hospital to adapt liquid cooling garment technology for use by surgical teams in order to allow them to work comfortably in warmer operating room environments.

Shuttle Extravehicular Mobility Unit (EMU) studies have shown that the thermal interaction between the crewperson, liquid cooling garment and EMU thermal management system is highly transient in nature. Recent investigations of these phenomena provide a better understanding which have helped improve thermal comfort in the present system. Analyses show that the key to thermal comfort is understanding the interaction between physiological responses and EMU system thermal transients. A test program was conducted to evaluate the theorized causes of discomfort and proposed corrective actions. Several EMU thermal management related modifications were utilized in the Hubble Space Telescope repair mission where five, two crewperson ExtraVehicular Activities (EVAs) were conducted without any thermal discomfort in a mildly cold environment.