Comparative effects of warming systems applied to different parts of the body on hypothermia in adults undergoing abdominal surgery: A systematic review and network meta-analysis of randomized controlled trials

Yi Chen Chen, Yih Giun Cherng, Debby Syahru Romadlon, Kai Mei Chang, Chun Jen Huang, Pei Shan Tsai, Chien Yu Chen, Hsiao Yean Chiu

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Study objective: The prevention of perioperative hypothermia after anesthesia induction is a critical concern in patients undergoing abdominal surgery. The effectiveness of various warming systems for preventing hypothermia and shivering when applied to specific areas of the body remains undetermined. Design: Systematic review and network meta-analysis. Setting: Operating room. Intervention: Five electronic databases were searched, including only randomized control trials (RCTs) reporting the effects of warming systems applied to specific body sites on the intraoperative core temperature and postoperative risk of shivering in adults undergoing abdominal surgery. A multivariate random-effects network meta-analysis with a frequentist framework was implemented for data analysis. Measurements: The primary outcome was the core body temperature 60 and 120 min after anesthesia induction for abdominal surgery. The secondary outcome was the incidence of postoperative shivering. Results: This review comprised a total of 24 RCTs including 1119 patients. At 60 and 120 min after anesthesia induction, a forced-air warming system applied to the upper body (0.3 °C and 95% confidence intervals = [0.3 to 0.4], 1.0 °C [0.7 to 1.3]), lower body (0.4 °C [0.3 to 0.5], 0.9 °C [0.5 to 1.2]), and underbody (0.5 °C [0.5 to 0.6], 1.2 °C [0.9 to 1.6]) was superior to passive insulation in terms of core body temperature regulation. Compared with passive insulation, the forced-air warming system applied to the lower body (odds ratio = 0.06) or underbody (0.44) and the electric heating blanket to the lower body (0.02) or the whole body (0.07) significantly reduced the risk of shivering. Conclusions: The results of this NMA revealed that forced-air warming with an underbody blanket effectively elevates core body temperatures in 60 and 120 min after induction of anesthesia and prevents shivering in patients recovering from abdominal surgery.

Original languageEnglish
Article number111190
JournalJournal of Clinical Anesthesia
Volume89
DOIs
Publication statusPublished - Oct 2023

Keywords

  • Abdominal surgery
  • Core temperature regulation
  • Hypothermia
  • Network meta-analysis
  • Shivering

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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