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Meta-Analysis
. 2016 Apr 21;4(4):CD009016.
doi: 10.1002/14651858.CD009016.pub2.

Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults

Eva Madrid  1 , Gerard Urrútia, Marta Roqué i Figuls, Hector Pardo-Hernandez, Juan Manuel Campos, Pilar Paniagua, Luz Maestre, Pablo Alonso-Coello
Affiliations
Meta-Analysis

Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults

Eva Madrid et al. Cochrane Database Syst Rev. .

Abstract

Background: Inadvertent perioperative hypothermia is a phenomenon that can occur as a result of the suppression of the central mechanisms of temperature regulation due to anaesthesia, and of prolonged exposure of large surfaces of skin to cold temperatures in operating rooms. Inadvertent perioperative hypothermia has been associated with clinical complications such as surgical site infection and wound-healing delay, increased bleeding or cardiovascular events. One of the most frequently used techniques to prevent inadvertent perioperative hypothermia is active body surface warming systems (ABSW), which generate heat mechanically (heating of air, water or gels) that is transferred to the patient via skin contact.

Objectives: To assess the effectiveness of pre- or intraoperative active body surface warming systems (ABSW), or both, to prevent perioperative complications from unintended hypothermia during surgery in adults.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 9, 2015); MEDLINE (PubMed) (1964 to October 2015), EMBASE (Ovid) (1980 to October 2015), and CINAHL (Ovid) (1982 to October 2015).

Selection criteria: We included randomized controlled trials (RCTs) that compared an ABSW system aimed at maintaining normothermia perioperatively against a control or against any other ABSW system. Eligible studies also had to include relevant clinical outcomes other than measuring temperature alone.

Data collection and analysis: Several authors, by pairs, screened references and determined eligibility, extracted data, and assessed risks of bias. We resolved disagreements by discussion and consensus, with the collaboration of a third author.

Main results: We included 67 trials with 5438 participants that comprised 79 comparisons. Forty-five RCTs compared ABSW versus control, whereas 18 compared two different types of ABSW, and 10 compared two different techniques to administer the same type of ABSW. Forced-air warming (FAW) was by far the most studied intervention.Trials varied widely regarding whether the interventions were applied alone or in combination with other active (based on a different mechanism of heat transfer) and/or passive methods of maintaining normothermia. The type of participants and surgical interventions, as well as anaesthesia management, co-interventions and the timing of outcome measurement, also varied widely. The risk of bias of included studies was largely unclear due to limitations in the reports. Most studies were open-label, due to the nature of the intervention and the fact that temperature was usually the principal outcome. Nevertheless, given that outcome measurement could have been conducted in a blinded manner, we rated the risk of detection and performance bias as high.The comparison of ABSW versus control showed a reduction in the rate of surgical site infection (risk ratio (RR) 0.36, 95% confidence interval (CI) 0.20 to 0.66; 3 RCTs, 589 participants, low-quality evidence). Only one study at low risk of bias observed a beneficial effect with forced-air warming on major cardiovascular complications (RR 0.22, 95% CI 0.05 to 1.00; 1 RCT with 12 events, 300 participants, low-quality evidence) in people at high cardiovascular risk. We found no beneficial effect for mortality. ABSW also reduced blood loss during surgery but the magnitude of this effect seems to be irrelevant (MD -46.17 mL, 95% CI -82.74 to -9.59; I² = 78%; 20 studies, 1372 participants). The same conclusion applies to total fluids infused during surgery (MD -144.49 mL, 95% CI -221.57 to -67.40; I² = 73%; 24 studies, 1491 participants). These effects did not translate into a significant reduction in the number of participants being transfused or the average amount of blood transfused. ABSW was associated with a reduction in shivering (RR 0.39, 95% CI 0.28 to 0.54; 29 studies, 1922 participants) and in thermal comfort (standardized mean difference (SMD) 0.76, 95% CI 0.29 to 1.24; I² = 77%, 4 trials, 364 participants).For the comparison between different types of ABSW system or modes of administration of a particular type of ABSW, we found no evidence for the superiority of any system in terms of clinical outcomes, except for extending systemic warming to the preoperative period in participants undergoing major abdominal surgery (one study at low risk of bias).There were limited data on adverse effects (the most relevant being thermal burns). While some trials included a narrative report mentioning that no adverse effects were observed, the majority made no reference to it. Nothing so far suggests that ABSW involves a significant risk to patients.

Authors' conclusions: Forced-air warming seems to have a beneficial effect in terms of a lower rate of surgical site infection and complications, at least in those undergoing abdominal surgery, compared to not applying any active warming system. It also has a beneficial effect on major cardiovascular complications in people with substantial cardiovascular disease, although the evidence is limited to one study. It also improves patient's comfort, although we found high heterogeneity among trials. While the effect on blood loss is statistically significant, this difference does not translate to a significant reduction in transfusions. Again, we noted high heterogeneity among trials for this outcome. The clinical relevance of blood loss reduction is therefore questionable. The evidence for other types of ABSW is scant, although there is some evidence of a beneficial effect in the same direction on chills/shivering with electric or resistive-based heating systems. Some evidence suggests that extending systemic warming to the preoperative period could be more beneficial than limiting it only to during surgery. Nothing suggests that ABSW systems pose a significant risk to patients.The difficulty in observing a clinically-relevant beneficial effect with ABSW in outcomes other than temperature may be explained by the fact that many studies applied concomitant procedures that are routinely in place as co-interventions to prevent hypothermia, whether passive or active warming systems based in other physiological mechanisms (e.g. irrigation fluid or gas warming), as well as a stricter control of temperature in the context of the study compared with usual practice. These may have had a beneficial effect on the participants in the control group, leading to an underestimation of the net benefit of ABSW.

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Conflict of interest statement

Eva Madrid has no conflicts of interest to declare.

Gerard Urrútia has received consultant fees from Novartis and payments for a methodological workshops from RIMA, Novartis and GSK (addressed to lab representatives or doctors). His institution has received a grant from Instituto de Salud Carlos III (Grant PI08/90403) (Public funding to produce a technology assessment report on forced‐air warming).

Marta Roqué i Figuls has no conflicts of interest to declare.

Hector Pardo Hernandez has no conflicts of interest to declare.

Pablo Alonso‐Coello has no conflicts of interest to declare.

Joan M Campos has no conflicts of interest to declare.

Pilar Paniagua has received payment from CSL Behringer for development of educational presentations about coagulation management in massive bleeding patients.

Luz Maestre has no conflicts of interest to declare.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 1 Active warming systems vs control (no active warming), outcome: 1.12 Chills/shivering.
1.1
1.1. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 1 Surgical site infection and complications.
1.2
1.2. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 2 All‐cause mortality.
1.3
1.3. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 3 Blood transfusions during surgery and up to 48 hours post‐surgery (ml).
1.4
1.4. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 4 Participants transfused.
1.5
1.5. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 5 Blood loss (ml).
1.6
1.6. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 6 Fluids infused (ml).
1.7
1.7. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 7 Participant's thermal comfort (higher values mean higher comfort).
1.8
1.8. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 8 Participant's thermal sensation (higher values mean 'insufferably hot').
1.9
1.9. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 9 Pain < 12 hours.
1.10
1.10. Analysis
Comparison 1 Active warming vs control (no active warming), Outcome 10 Chills/shivering.
2.1
2.1. Analysis
Comparison 2 Forced‐air warming vs electric and resistive heating systems, Outcome 1 Blood loss during surgery and up to 48 hours post‐surgery (ml).
2.2
2.2. Analysis
Comparison 2 Forced‐air warming vs electric and resistive heating systems, Outcome 2 Fluids infused (ml).
2.3
2.3. Analysis
Comparison 2 Forced‐air warming vs electric and resistive heating systems, Outcome 3 Participant's comfort (thermal).
2.4
2.4. Analysis
Comparison 2 Forced‐air warming vs electric and resistive heating systems, Outcome 4 Chills/shivering.
3.1
3.1. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 1 Surgical site infection.
3.2
3.2. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 2 Participants transfused.
3.3
3.3. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 3 Blood transfusions.
3.4
3.4. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 4 Blood loss (ml).
3.5
3.5. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 5 Fluids infused (ml).
3.6
3.6. Analysis
Comparison 3 Forced‐air warming vs warm water circulation systems, Outcome 6 Chills/shivering.
4.1
4.1. Analysis
Comparison 4 Forced‐air warming vs radiant heat, Outcome 1 Chills/shivering.
5.1
5.1. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 1 Surgical site infection and complications.
5.2
5.2. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 2 Major cardiovascular complications (cardiovascular death, non‐fatal myocardial infarction, non‐fatal stroke, and non‐fatal cardiac arrest).
5.3
5.3. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 3 Non‐fatal myocardial infarction.
5.4
5.4. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 4 Non‐fatal cardiac arrest.
5.5
5.5. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 5 Blood transfusions during surgery and up to 48 hours post‐surgery (mL).
5.6
5.6. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 6 Participants transfused.
5.7
5.7. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 7 Blood loss during surgery ‐ mL.
5.8
5.8. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 8 Fluids transfused during surgery ‐ mL.
5.9
5.9. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 9 Participant's anxiety and state.
5.10
5.10. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 10 Participant's comfort (thermal) (higher values mean higher comfort).
5.11
5.11. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 11 Pain.
5.12
5.12. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 12 Chills/shivering.
5.13
5.13. Analysis
Comparison 5 Active vs no active (subgroup analysis by anaesthesia type), Outcome 13 All cause mortality.
6.1
6.1. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 1 Infection and complications of the surgical wound.
6.2
6.2. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 2 Major cardiovascular complications (cardiovascular death, non‐fatal myocardial infarction, non‐fatal stroke, and non‐fatal cardiac arrest).
6.3
6.3. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 3 Non‐fatal myocardial infarction.
6.4
6.4. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 4 Non‐fatal cardiac arrest.
6.5
6.5. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 5 Blood transfusions during surgery and up to 48 hours post‐surgery (mL).
6.6
6.6. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 6 Participants transfused.
6.7
6.7. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 7 Blood loss during surgery ‐ mL.
6.8
6.8. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 8 Fluids transfused during surgery ‐ mL.
6.9
6.9. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 9 Participant's anxiety and state.
6.10
6.10. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 10 Participant's comfort (thermal) (higher values mean higher comfort).
6.11
6.11. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 11 Pain.
6.12
6.12. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 12 Chills/shivering.
6.13
6.13. Analysis
Comparison 6 Active vs no active (subgroup analysis by timing of intervention), Outcome 13 All‐cause mortality.
7.1
7.1. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 1 Infection and complications of the surgical wound.
7.2
7.2. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 2 Major cardiovascular complications (cardiovascular death, non‐fatal myocardial infarction, non‐fatal stroke, and non‐fatal cardiac arrest).
7.3
7.3. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 3 Non‐fatal myocardial infarction.
7.4
7.4. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 4 Non‐fatal cardiac arrest.
7.5
7.5. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 5 Blood transfusions during surgery and up to 48 hours post‐surgery (mL).
7.6
7.6. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 6 Participants transfused.
7.7
7.7. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 7 Blood loss during surgery ‐ mL.
7.8
7.8. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 8 Fluids transfused during surgery ‐ mL.
7.9
7.9. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 9 Participant's comfort (thermal) (higher values mean higher comfort).
7.10
7.10. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 10 Pain.
7.11
7.11. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 11 Chills/shivering.
7.12
7.12. Analysis
Comparison 7 Active vs no active (sensitivity analysis by surgery duration ≥ 120 min), Outcome 12 All‐cause mortality.
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References

References to studies included in this review

Andrzejowski 2008 {published data only}
    1. Andrzejowski J, Hoyle J, Eapen G, Turnbull D. Effect of prewarming on post‐induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia. British Journal of Anaesthesia 2008;101(5):627‐31. - PubMed
Bennett 1994 {published data only}
    1. Bennett J, Ramachandra V, Webster J, Carli F. Prevention of hypothermia during hip surgery: effect of passive compared with active skin surface warming. British Journal of Anaesthesia 1994;73(2):180‐3. - PubMed
Benson 2012 {published data only}
    1. Benson EE, McMillan DE, Ong B. The effects of active warming on patient temperature and pain after total knee arthroplasty. The American Journal of Nursing 2012;112(5):26‐33. - PubMed
Bock 1998 {published data only}
    1. Bock M, Müller J, Bach A, Böhrer H, Martin E, Motsch J. Effects of preinduction and intraoperative warming during major laparotomy. British Journal of Anaesthesia 1998;80(2):159‐63. - PubMed
Butwick 2007 {published data only}
    1. Butwick AJ, Lipman SS, Carvalho B. Intraoperative forced air‐warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. Anesthesia and Analgesia 2007;105(5):1413‐9. - PubMed
Calcaterra 2009 {published data only}
    1. Calcaterra D, Ricci M, Lombardi P, Katariya K, Panos A, Salerno TA. Reduction of postoperative hypothermia with a new warming device: a prospective randomized study in off‐pump coronary artery surgery. The Journal of Cardiovascular Surgery 2009;50(6):813‐7. - PubMed
Campos‐Suárez 1997 {published data only}
    1. Campos‐Suárez JM, Casas‐Vila JI, Litvan‐Suquieni H, Villar‐Landeira JM. Air‐convection heater for abdominal surgery. Study of the relation between surgical time and the efficacy of body temperature maintenance [Calentador por convección de aire en cirugía abdominal. Estudio de la relación tiempo quirúrgico‐eficacia del mantenimiento de la temperatura corporal]. Revista Española de Anestesiología y Reanimación 1997;44(2):47‐51. - PubMed
Camus 1993a {published data only}
    1. Camus Y, Delva E, Just B, Lienhart A. Leg warming minimizes core hypothermiaduring abdominal surgery. Anesthesia and Analgesia 1993;77(5):995‐9. - PubMed
Camus 1993b {published data only}
    1. Camus Y, Delva E, Just B, Lienhart AL. Leg warming minimizes core hypothermiaduring abdominal surgery. Anesthesia and Analgesia 1993;77(5):995‐99. - PubMed
Camus 1995 {published data only}
    1. Camus Y, Delva E, Sessler DI, Lienhart A. Pre‐induction skin‐surface warming minimizes intraoperative core hypothermia. Journal of Clinical Anesthesia 1995;7(5):384‐8. - PubMed
Camus 1997 {published data only}
    1. Camus Y, Delva E, Bossard AE, Chandon M, Lienhart A. Prevention of hypothermia by cutaneous warming with new electric blankets during abdominal surgery. British Journal of Anaesthesia 1997;79(6):796‐7. - PubMed
Casati 1999a {published data only}
    1. Casati A, Baroncini S, Pattono R, Fanelli G, Bonarelli S, Musto P, et al. Effects of sympathetic blockade on the efficiency of forced‐air warming during combined spinal‐epidural anesthesia for total hip arthroplasty. Journal of Clinical Anesthesia 1999;11(5):360‐3. - PubMed
Casati 1999b {published data only}
    1. Casati A, Fanelli G, Ricci A, Musto P, Cedrati V, Altimari G, et al. Shortening the discharging time after total hip replacement under combined spinal/epidural anesthesia by actively warming the patient during surgery. Minerva Anestesiologica 1999;65(7‐8):507‐14. - PubMed
Chakladar 2014 {published data only}
    1. Chakladar A, Dixon MJ, Crook D, Harper CM. The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial. International Journal of Obstetric Anesthesia 2014;23(4):309‐16. - PubMed
Chung 2012 {published data only}
    1. Chung SH, Lee BS, Yang HJ, Kweon KS, Kim HH, Song J, et al. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean Journal of Anesthesiology 2012;62(5):454‐60. - PMC - PubMed
D'Angelo Vanni 2007 {published data only}
    1. D'Angelo Vanni SM, Castiglia YM, Ganem EM, Rodrigues Júnior GR, Amorim RB, Ferrari F, et al. Preoperative warming combined with intraoperative skin‐surface warming does not avoid hypothermia caused by spinal anesthesia in patients with midazolam premedication. São Paulo Medical Journal 2007;125(3):144‐9. - PMC - PubMed
Elmore 1998 {published data only}
    1. Elmore JR, Franklin DP, Youkey JR, Oren JW, Frey CM. Normothermia is protective during infrarenal aortic surgery. Journal of Vascular Surgery 1998;28(6):984‐92. - PubMed
Fallis 2006 {published data only}
    1. Fallis WM, Hamelin K, Symonds J, Wang X. Maternal and newborn outcomes related to maternal warming during cesarean delivery. Journal of Obstetric, Gynecologic, and Neonatal Nursing 2006;35(3):324‐31. - PubMed
Fossum 2001 {published data only}
    1. Fossum S, Hays J, Henson MM. A comparison study on the effects of prewarming patients in the outpatient surgery setting. Journal of Perianesthesia Nursing 2001;16(3):187‐94. - PubMed
Frank 1997 {published data only}
    1. Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA 1997;277(14):1127‐34. - PubMed
Hasegawa 2012 {published data only}
    1. Hasegawa K, Negishi C, Nakagawa F, Ozaki M. Core temperatures during major abdominal surgery in patients warmed with new circulating‐water garment, forced‐air warming, or carbon‐fiber resistive‐heating system. Journal of Anesthesia 2012;26(2):168‐73. - PMC - PubMed
    1. Negishi C, Hasegawa K, Mukai S, Nakagawa F, Ozaki M, Sessler DI. Resistive‐heating and forced‐air warming are comparably effective. Anesthesia and Analgesia 2003;96(6):1683‐7. - PubMed
Hofer 2005 {published data only}
    1. Hofer CK, Worn M, Tavakoli R, Sander L, Maloigne M, Klaghofer R, et al. Influence of body core temperature on blood loss and transfusion requirements during off‐pump coronary artery bypass grafting: a comparison of 3 warming systems. The Journal of Thoracic and Cardiovascular Surgery 2005;129(4):838‐43. - PubMed
Horn 2002 {published data only}
    1. Horn EP, Schroeder F, Gottschalk A, Sessler DI, Hiltmeyer N, Standl T, et al. Active warming during cesarean delivery. Anesthesia and Analgesia 2002;94(2):409‐14. - PubMed
Horn 2012 {published data only}
    1. Horn EP, Bein B, Bohm R, Steinfath M, Sahili N, Hocker J. The effect of short time periods of pre‐operative warming in the prevention of peri‐operative hypothermia. Anaesthesia 2012;67(6):612‐7. - PubMed
Janicki 2001 {published data only}
    1. Janicki PK, Higgins MS, Janssen J, Johnson RF, Beattie C. Comparison of two different temperature maintenance strategies during open abdominal surgery: upper body forced‐air warming versus whole body water garment. Anesthesiology 2001;95(4):868‐74. - PubMed
Johansson 1999 {published data only}
    1. Johansson T, Lisander B, Ivarsson I. Mild hypothermia does not increase blood loss during total hip arthroplasty. Acta Anaesthesiologica Scandinavica 1999;43(10):1005‐10. - PubMed
Just 1993 {published data only}
    1. Just B, Trévien V, Delva E, Lienhart A. Prevention of intraoperative hypothermia by preoperative skin‐surface warming. Anesthesiology 1993;79(2):214‐8. - PubMed
Kabbara 2002 {published data only}
    1. Kabbara A, Goldlust SA, Smith CE, Hagen JF, Pinchak AC. Randomized prospective comparison of forced air warming using hospital blankets versus commercial blankets in surgical patients. Anesthesiology 2002;97(2):338‐44. - PubMed
Kiessling 2006 {published data only}
    1. Kiessling AH, Isgro F, Lehmann A, Piper S, Blome M, Saggau W. Evaluating a new method for maintaining body temperature during OPCAB and robotic procedures. Medical Science Monitor 2006;12(7):MT39‐42. - PubMed
Kim 2014 {published data only}
    1. Kim HY, Lee KC, Lee MJ, Kim MN, Kim JS, Lee WS, et al. Comparison of the efficacy of a forced‐air warming system and circulating‐water mattress on core temperature and post‐anesthesia shivering in elderly patients undergoing total knee arthroplasty under spinal anesthesia. Korean Journal of Anesthesiology 2014;66(5):352‐7. - PMC - PubMed
Krenzinschek 1995 {published data only}
    1. Krenzischek DA, Frank SM, Kelly S. Forced‐air warming versus routine thermal care and core temperature measurement sites. Journal of Post Anesthesia Nursing 1995;10(2):69‐78. - PubMed
Kurz 1995 {published data only}
    1. Kurz A, Sessler DI, Narzt E, Bekar A, Lenhardt R, Huemer G, et al. Postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia. Journal of Clinical Anesthesia 1995;7(5):359‐66. - PubMed
Kurz 1996 {published data only}
    1. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical‐wound infection and shorten hospitalization. Study of Wound Infectionand Temperature Group. New England Journal of Medicine 1996;334(19):1209‐15. - PubMed
Lee 2004 {published data only}
    1. Lee L, Leslie K, Kayak E, Myles PS. Intraoperative patient warming using radiant warming or forced‐air warming during long operations. Anaesthesia and Intensive Care 2004;32(3):358‐61. - PubMed
Leeth 2010 {published data only}
    1. Leeth D, Mamaril M, Oman KS, Krumbach B. Normothermia and patient comfort: a comparative study in an outpatient surgery setting. Journal of Perianesthesia Nursing 2010;25(3):146‐51. - PubMed
Leung 2007 {published data only}
    1. Leung KK, Lai A, Wu A. A randomised controlled trial of the electric heating pad vs forced‐air warming for preventing hypothermia during laparotomy. Anaesthesia 2007;62(6):605‐8. - PubMed
Lindwall 1998 {published data only}
    1. Lindwall R, Svensson H, Söderström S, Blomqvist H. Forced air warming and intraoperative hypothermia. The European Journal of Surgery 1998;164(1):13‐6. - PubMed
Mason 1998 {published data only}
    1. Mason DS, Sapala JA, Wood MH, Sapala MA. Influence of a forced air warming system on morbidly obese patients undergoing Roux‐en‐Y gastric bypass. Obesity Surgery 1998;8(4):453‐60. - PubMed
Matsukawa 1994 {published data only}
    1. Matsukawa T, Kashimoto S, Nakamura T, Kume M, Kanda F, Kumazawa T. Effects of a forced‐air system (Bair Hugger, OR‐type) on intraoperative temperature in patients with open abdominal surgery. Journal of Anesthesia 1994;8(1):25‐7. - PubMed
Melling 2001 {published data only}
    1. Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet 2001;358(9285):876‐80. - PubMed
Mogera 1997 {published data only}
    1. Mogera H, Dash H, Chaturvedi A, Tewari R, Bhutara S. Control of body temperature with forced‐air warming system during neurosurgery. Journal of Anaesthesiology Clinical Pharmacology 1997;13(3):207‐12.
Moysés 2014 {published data only}
    1. Moysés AM, Dos Santos Trettene A, Navarro LH, Ayres JA. Hypothermia prevention during surgery: comparison between thermal mattress and thermal blanket. Revista de Escola de Enfermagem USP 2014;48(2):228‐35. - PubMed
Ng 2003 {published data only}
    1. Ng SF, Oo CS, Loh KH, Lim PY, Chan YH, Ong BC. A comparative study of three warming interventions to determine the most effective inmaintaining perioperative normothermia. Anesthesia and Analgesia 2003;96(1):171‐6. - PubMed
Ng 2006 {published data only}
    1. Ng V, Lai A, Ho V. Comparison of forced‐air warming and electric heating pad for maintenance of body temperature during total knee replacement. Anaesthesia 2006;61(11):1100‐4. - PMC - PubMed
O'Brien 2010 {published data only}
    1. O'Brien D, Greenfield ML, Anderson JE, Smith BA, Morris M. Comfort, satisfaction, and anxiolysis in surgical patients using a patient‐adjustable comfort warming system: a prospective randomized clinical trial. Journal of Perianesthesia Nursing 2010;25(2):88‐93. - PubMed
Pagnocca 2009 {published data only}
    1. Pagnocca ML, Tai EJ, Dwan JL. Temperature control in conventional abdominal surgery: comparison between conductive and the association of conductive and convective warming. Revista Brasileira de Anestesiologia 2009;59(1):56‐66. - PubMed
Paris 2014 {published data only}
    1. Paris LG, Seitz M, McElroy KG, Regan M. A randomized controlled trial to improve outcomes utilizing various warming techniques during cesarean birth. Journal of Obstetric, Gynecologic & Neonatal Nursing 2014;43:719‐28. - PubMed
Peña García 1996 {published data only}
    1. Peña García I, García Miguel M. Preventive measures. The risk of hypothermia during prolonged anesthesia and surgery. Study of methods of warming [Riesgo de hipotermia en anestesia y cirugía prolongadas. Estudio de dos métodos de calentamiento]. Revista de Enfermería 1996;19(211):24‐31. - PubMed
Perl 2014 {published data only}
    1. Perl T, Peichl LH, Reyntjens K, Deblaere I, Zaballos JM, Bräuer A. Efficacy of a novel prewarming system in the prevention of perioperativehypothermia. A prospective, randomized, multicenter study. Minerva Anestesiol 2014;80(4):436‐43. - PubMed
Persson 2001 {published data only}
    1. Persson K, Lundberg J. Perioperative hypothermia and postoperative opioid requirements. European Journal of Anaesthesiology 2001;18(10):679‐86. - PubMed
Pu 2014 {published data only}
    1. Pu Y, Cen G, Sun J, Gong J, Zhang Y, Zhang M, et al. Warming with an underbody warming system reduces intraoperative hypothermia in patients undergoing laparoscopic gastrointestinal surgery: A randomized controlled study. International Journal of Nursing Studies 2014;51(2):181‐9. - PubMed
Rasmussen 1998 {published data only}
    1. Rasmussen YH, Leikersfeldt G, Drenck NE. Forced‐air surface warming versusoesophageal heat exchanger in the prevention of peroperative hypothermia. Acta Anaesthesiologica Scandinavica 1998;42(3):348‐52. - PubMed
Rathinam 2009 {published data only}
    1. Rathinam S, Annam V, Steyn R, Raghuraman G. A randomised controlled trial comparing Mediwrap heat retention and forced air warming for maintaining normothermia in thoracic surgery. Interactive Cardiovascular and Thoracic Surgery 2009;9(1):15‐9. - PubMed
Schmied 1996 {published data only}
    1. Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet 1996;347(8997):289‐92. - PubMed
Scott 2001 {published data only}
    1. Scott EM, Leaper DJ, Clark M, Kelly PJ. Effects of warming therapy on pressure ulcers‐a randomized trial. AORN Journal 2001;73(5):921‐7, 929‐33, 936‐8. - PubMed
Steinbrook 1997 {published data only}
    1. Steinbrook RA, Seigne PW. Total‐body oxygen consumption after isoflurane anesthesia: effects of mild hypothermia and combined epidural‐general anesthesia. Journal of Clinical Anesthesia 1997;9(7):559‐63. - PubMed
Suraseranivongse 2009 {published data only}
    1. Suraseranivongse S, Pongraweewan O, Kongmuang B, Tivirach W, Pornboonseram S. A custom‐made forced‐air warming mattress for heat loss prevention during vascular surgery: clinical evaluation. Asian Biomedicine 2009;3(3):299‐307.
Tanaka 2013 {published data only}
    1. Tanaka N, Ohno Y, Hori M, Utada M, Ito K, Suzuki T. A randomised controlled trial of the resistive heating blanket versus the convective warming system for preventing hypothermia during major abdominal surgery. Journal of Perioperative Practice 2013;23(4):82‐6. - PubMed
Torrie 2005 {published data only}
    1. Torrie JJ, Yip P, Robinson E. Comparison of forced‐air warming and radiant heating during transurethral prostatic resection under spinal anaesthesia. Anaesthesia and Intensive Care 2005;33(6):773‐8. - PubMed
Vassiliades 2003 {published data only}
    1. Vassiliades TA Jr, Nielsen JL, Lonquist JL. Evaluation of a new temperature management system during off‐pump coronary artery bypass. Interactive Cardiovascular and Thoracic Surgery 2003;2(4):454‐7. - PubMed
Winkler 2000 {published data only}
    1. Winkler M, Akca O, Birkenberg B, Hetz H, Scheck T, Arkilic CF, et al. Aggressive warming reduces blood loss during hip arthroplasty. Anesthesia and Analgesia 2000;91(4):978‐84. - PubMed
Wong 2007 {published data only}
    1. Wong PF, Kumar S, Bohra A, Whetter D, Leaper DJ. Randomized clinical trial of perioperative systemic warming in major elective abdominal surgery. The British Journal of Surgery 2007;94(4):421‐6. - PubMed
Wongprasartsuk 1998 {published data only}
    1. Wongprasartsuk P, Konstantatos A, McRae R. The effect of forced air warming on postoperative oxygen consumption and temperature in elective orthopaedic surgery. Anaesthesia and Intensive Care 1998;26(3):267‐71. - PubMed
Yamakage 1995 {published data only}
    1. Yamakage M, Kawana S, Yamauchi M, Kohro S, Namiki A. Evaluation of a forced air warning system during spinal anesthesia. Journal of Anesthesia 1995;9(1):93‐5. - PubMed
Yildirim 2012 {published data only}
    1. Yildirim S, Unal CB, Dongel I, Duger C, Sahin AF, Ersan I. Effects of intraoperative skin surface warming on postanesthetic recovery and shivering: A prospective, randomized, clinical trial. Health MED 2012;6(10):3340‐5.
Zangrillo 2006 {published data only}
    1. Zangrillo A, Pappalardo F, Talò G, Corno C, Landoni G, Scandroglio A, et al. Temperature management during off‐pump coronary artery bypass graft surgery: a randomizedclinical trial on the efficacy of a circulating water system versus a forced‐air system. Journal of Cardiothoracic and Vascular Anesthesia 2006;20(6):788‐92. - PubMed
Zhao 2005 {published data only}
    1. Zhao J, Luo AL, Xu L, Huang YG. Forced‐air warming and fluid warming minimize core hypothermia during abdominal surgery. Chinese Medical Sciences Journal 2005;20(4):261‐4. - PubMed

References to studies excluded from this review

Allen 2009 {published data only}
    1. Allen GS. Intraoperative temperature control using the Thermogard system during off‐pump coronary artery bypass grafting. The Annals of Thoracic Surgery 2009;87(1):284‐8. - PubMed
Baxendale 2000 {published data only}
    1. Baxendale B, Giovanelli M, Bennett M. Comparison of the Inditherm Mattress and forced‐air patient warming device during major abdominal and orthopaedic surgery. Available at: http://www.inditherm.co.uk/medical/patient‐warming‐perioperative‐and‐icu... 2000 (Accessed 15th April 2016)).
Berti 1997 {published data only}
    1. Berti M, Casati A, Torri G, Aldegheri G, Lugani D, Fanelli G. Active warming, not passive heat retention, maintains normothermia during combined epidural‐general anesthesia for hip and knee arthroplasty. Journal of Clinical Aanesthesia 1997;9(6):482‐6. - PubMed
Borms 1994 {published data only}
    1. Borms SF, Engelen SL, Himpe DG, Suy MR, Theunissen WJ. Bair hugger forced‐air warming maintains normothermia more effectively than thermo‐lite insulation. Journal of Clinical Anesthesia 1994;6(4):303‐7. - PubMed
Bourke 1984 {published data only}
    1. Bourke DL, Wurm H, Rosenberg M, Russell J. Intraoperative heat conservation using a reflective blanket. Anesthesiology 1984;60(2):151‐4. - PubMed
Buggy 1994 {published data only}
    1. Buggy D, Hughes N. Pre‐emptive use of the space blanket reduces shivering after general anaesthesia. British Journal of Anaesthesia 1994;72(4):393‐6. - PubMed
Cobbe 2012 {published data only}
    1. Cobbe KA, Staso R, Duff J, Walker K, Draper N. Preventing inadvertent hypothermia: comparing two protocols for preoperative forced‐air warming. Journal of Perianesthesia Nursing 2012;27(1):18‐24. - PubMed
De Bernardis 2009 {published data only}
    1. Bernardis RC, Prado Da Silva M, Lauzi Y, Gozzani JL, Lacava Pagnocca M. (Use of forced‐air to prevent intraoperative hypothermia) [Uso da manta termica na prevençao da hipotermia intraoperatoria]. Revista da Associação Brasileira de Medicina Psicossomática 2009;55(4):421‐6. - PubMed
Dyer 1986 {published data only}
    1. Dyer PM, Heathcote PS. Reduction of heat loss during transurethral resection of the prostate. Anaesthesia and Intensive Care 1986;14(1):12‐6. - PubMed
Erickson 1991 {published data only}
    1. Erickson RS, Yount ST. Effect of aluminized covers on body temperature in patients having abdominal surgery. Heart Lung 1991;20(3):255‐64. - PubMed
Fanelli 2009 {published data only}
    1. Fanelli A, Danelli G, Ghisi D, Ortu A, Moschini E, Fanelli G. The efficacy of a resistive heating under‐patient blanket versus a forced‐airwarming system: a randomized controlled trial. Anesthesia and Analgesia 2009;108(1):199‐201. - PubMed
Farley 2004 {published data only}
    1. Farley DR, Greenlee SM, Larson DR, Harrington JR. Double‐blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy. Archives of Surgery 2004;139(7):739‐44. - PubMed
Fleisher 1998 {published data only}
    1. Fleisher LA, Metzger SE, Lam J, Harris A. Perioperative cost‐finding analysis of the routine use of intraoperative forced‐air warming during general anesthesia. Anesthesiology 1998;88(5):1357‐64. - PubMed
Frank 1995 {published data only}
    1. Frank SM, Higgins MSM, Breslow MJM, Fleisher LAM, Gorman RBM, Sitzmann JVM, et al. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia: a randomized clinical trial. Anesthesiology 1995;82(1):83‐93. - PubMed
Grocott 2004 {published data only}
    1. Grocott HP, Mathew JP, Carver EH, Phillips‐Bute B, Landolfo KP, Newman MF. A randomized controlled trial of the Arctic Sun Temperature Management System versus conventional methods for preventing hypothermia during off‐pump cardiac surgery. Anesthesia and Analgesia 2004;98(2):298‐302. - PubMed
Harper 2007 {published data only}
    1. Harper C. Is a warming mattress as effective as forced‐air warming in preventing peri‐operative hypothermia?. Anesthesiology 2007;107(A):92.
Hindsholm 1992 {published data only}
    1. Hindsholm KB, Bredahl C, Herlevsen P, Kruhoffer PK. Reflective blankets used for reduction of heat loss during regional anaesthesia. British Journal of Anaesthesia 1992;68(5):531‐3. - PubMed
Hoyt 1993 {published data only}
    1. Hoyt K, Clochesy JM, Shamsali S, Bracken W. Comparison of the effect of insulated and noninsulated head covers on heat loss during abdominal surgery. Nurse Anesthesia 1993;4(1):4‐8. - PubMed
Hynson 1992 {published data only}
    1. Hynson JM, Sessler DI. Intraoperative warming therapies: a comparison of three devices. Journal of Clinical Anesthesia 1992;4(3):194‐9. - PubMed
Insler 2008 {published data only}
    1. Insler SR, Bakri MH, Nageeb F, Mascha E, Mihaljevic T, Sessler DI. An evaluation of a full‐access underbody forced‐air warming system during near‐normothermic, on‐pump cardiac surgery. Anesthesia & Analgesia 2008;106(3):746‐50. - PubMed
Janicki 2002 {published data only}
    1. Janicki PK, Stoica C, Chapman WC, Wright JK, Walker G, Pai R, et al. Water warming garment versus forced air warming system in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832]. BMC Anesthesiology 2002;2(1):7. - PMC - PubMed
Joachimsson 1987 {published data only}
    1. Joachimsson PO, Nystrom SO, Tyden H. Heating efficacy of external heat supply during and after open‐heart surgery with hypothermia. Acta Anaesthesiologica Scandinavica 1987;31(1):73‐80. - PubMed
Kamitani 1999 {published data only}
    1. Kamitani K, Higuchi A, Takebayashi T, Miyamoto Y, Yoshida H. Covering the head and face maintains intraoperative core temperature. Canadian Journal of Anaesthesia 1999;46(7):649‐52. - PubMed
Karayan 1996 {published data only}
    1. Karayan J, Thomas D, Lacoste L, Dhoste K, Ricco JB, Fusciardi J. Delayed forced air warming prevents hypothermia during abdominal aortic surgery. British Journal of Anaesthesia 1996;76(3):459‐60. - PubMed
Kim 2006 {published data only}
    1. Kim JY, Shinn H, Oh YJ, Hong YW, Kwak HJ, Kwak YL. The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off‐pump coronary artery bypass surgery. European Journal of Cardiothoracic Surgery 2006;29(3):343‐7. - PubMed
Kongsayreepong 2002 {published data only}
    1. Kongsayreepong S, Gunnaleka P, Suraseranivongse S, Pirayavaraporn S, Chowvanayotin S, Montapaneewat, et al. A reusable, custom‐made warming blanket prevents core hypothermia during major neonatal surgery. Canadian Journal of Anaesthesia 2002;49(6):605‐9. - PubMed
Kurz 1993 {published data only}
    1. Kurz A, Kurz M, Poeschl G, Faryniak B, Redl G, Hackl W. Forced‐air warming maintains intraoperative normothermia better than circulating‐water mattresses. Anesthesia and Analgesia 1993;77(1):89‐95. - PubMed
Lenhardt 1997 {published data only}
    1. Lenhardt R, Marker E, Goll V, Tschernich H, Kurz A, Sessler DI, et al. Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology 1997;87(6):1318‐23. - PubMed
Matsuzaki 2003 {published data only}
    1. Matsuzaki Y, Matsukawa T, Ohki K, Yamamoto Y, Nakamura M, Oshibuchi T. Warming by resistive heating maintains perioperative normothermia as well as forced air heating. British Journal of Anaesthesia 2003;90(5):689‐91. - PubMed
Motamed 2000 {published data only}
    1. Motamed C, Labaille T, Léon O, Panzani JP, Duvaldestin P, Benhamou D. Core and thenar skin temperature variation during prolonged abdominal surgery: comparison of two sites of active forced air warming. Acta Anaesthesiologica Scandinavica 2000;44(3):249‐54. - PubMed
Müller 1993 {published data only}
    1. Müller CM, Gabriel A, Langenecker S, Hartmann T, Steltzer H, Werba A, et al. Effectiveness of rapid infusion and Bair Hugger systems in maintaining normothermia during orthotopic liver transplantation. Transplantation Proceedings 1993;25(2):1833‐4. - PubMed
Müller 1995 {published data only}
    1. Müller CM, Langenecker S, Andel H, Nantschev I, Hölzenbein TJ, Zimpfer M. Forced‐air warming maintains normothermia during orthotopic livertransplantation. Anaesthesia 1995;50(3):229‐32. - PubMed
Murat 1994 {published data only}
    1. Murat I, Bernière J, Constant I. Evaluation of the efficacy of a forced‐air warmer (Bair Hugger) during spinal surgery in children. Journal of Clinical Anesthesia 1994;6(5):425‐9. - PubMed
Nesher 2003 {published data only}
    1. Nesher N, Zisman E, Wolf T, Sharony R, Bolotin G, David M, et al. Strict thermoregulation attenuates myocardial injury during coronary artery bypass graft surgery as reflected by reduced levels of cardiac‐specific troponin I. Anesthesia and Analgesia 2003;96(2):328‐35. - PubMed
Onik 1993 {published data only}
    1. Onik GM, Chambers N, Chernus SA, Zemel R, Atkinson D, Weaver ML. Hepatic cryosurgery with and without the Bair Hugger. Journal of Surgical Oncology 1993;52(3):185‐7. - PubMed
Ouellette 1993 {published data only}
    1. Ouellette RG. Comparison of four intraoperative warming devices. AANA Journal 1993;61(4):394‐6. - PubMed
Patel 1997 {published data only}
    1. Patel N, Smith CE, Knapke D, Pinchak AC, Hagen JF. Heat conservation vs convective warming in adults undergoing elective surgery. Canadian Journal of Anaesthesia 1997;44(6):669‐73. - PubMed
Radel 1986 {published data only}
    1. Radel TJ, Fallacaro MD, Sievenpiper T. The effects of a warming vest and cap during lower extremity orthopedic surgical procedures under general anesthesia. AANA Journal 1986;54(6):486‐9. - PubMed
Radford 1979 {published data only}
    1. Radford P, Thurlow AC. Metallized plastic sheeting in the prevention of hypothermia during neurosurgery. British Journal of Anaesthesia 1979;51(3):237‐40. - PubMed
Rein 2007 {published data only}
    1. Rein EB, Filtvedt M, Walløe L, Raeder JC. Hypothermia during laparotomy can be prevented by locallyapplied warm water and pulsating negative pressure. British Journal of Anaesthesia 2007;98(3):331‐6. - PubMed
Russell 1995 {published data only}
    1. Russell SH, Freeman JW. Prevention of hypothermia during orthotopic liver transplantation: comparison of three different intraoperative warming methods. British Journal of Anaesthesia 1995;74(4):415‐8. - PubMed
Salazar 2011 {published data only}
    1. Salazar F, Donate M, Boget T, Bogdanovich A, Basora M, Torres F, et al. Intraoperative warming and post‐operative cognitive dysfunction after total knee replacement. Acta Anaesthesiologica Scandinavica 2011;55(2):216‐22. - PubMed
Saldanha 2001 {published data only}
    1. Saldanha C, Argano V, Nunn S, Zaidi A, Hadjinikolau L, Rees G, et al. Convective warming post bypass reduces postoperative bleeding. The Journal of Cardiovascular Surgery 2001;42(3):435‐6. - PubMed
Sessler 1988 {published data only}
    1. Sessler DI, Olofsson CI, Rubinstein EH. The thermoregulatory threshold in humans during nitrous oxide‐fentanylanesthesia. Anesthesiology 1988;69(3):357‐64. - PubMed
Severens 2007 {published data only}
    1. Severens NM, Marken Lichtenbelt WD, Leeuwen GM, Frijns AJ, Steenhoven AA, Mol BA, et al. Effect of forced‐air heaters on perfusion and temperature distribution during andafter open‐heart surgery. European Journal of Cardiothorac Surgery 2007;32(6):888‐95. - PubMed
Sheng 2003 {published data only}
    1. Sheng Y, Zavisca F, Schonlau E, Desmarattes R, Herron E, Cork R. The effect of preoperative reflective hats and jackets, and intraoperative reflective blankets on perioperative temperature. The Internet Journal of Anesthesiology 2003 (print.ispub.com/api/0/ispub‐article/11444); Vol. 6, issue 2:(Accessed 7th April 2016).
Smith 1994 {published data only}
    1. Smith I, Newson CD, White PF. Use of forced‐air warming during and after outpatient arthroscopic surgery. Anesthesia and Analgesia 1994;78(5):836‐41. - PubMed
Smith 2006 {published data only}
    1. Smith CE, Sidhu RS, Lucas L, Mehta D, Pinchak AC. Should patients undergoingambulatory surgery with general anesthesia be actively warmed?. Internet Journal of Anesthesiology 2006;12(1):18.
Summers 1990 {published data only}
    1. Summers S, Dudgeon N, Byram K, Zingsheim K. The effects of two warming methods on core and surface temperatures, hemoglobinoxygen saturation, blood pressure, and perceived comfort of hypothermic postanesthesia patients. Journal of Post Anesthesia Nursing 1990;5(5):354‐64. - PubMed
Tollofsrud 1984 {published data only}
    1. Tollofsrud SG, Gundersen Y, Andersen R. Perioperative hypothermia. Acta Anaesthesiologica Scandinavica 1984;28(5):511‐5. - PubMed
Wagner 2006 {published data only}
    1. Wagner D, Byrne M, Kolcaba K. Effects of comfort warming on preoperative patients. Association of Operating Room Nurses Journal 2006;84(3):427‐48. - PubMed
Whitney 1990 {published data only}
    1. Whitney AM. The efficiency of a reflective heating blanket in preventing hypothermia in patients undergoing intra‐abdominal procedures. AANA Journal 1990;58(3):212‐5. - PubMed
Wong 2004 {published data only}
    1. Wong A, Walker S, Bradley M. Comparison of a radiant patient warming device with forced air warming during laparoscopic cholecystectomy. Anaesthesia and Intensive Care 2004;32(1):93‐9. - PubMed

References to studies awaiting assessment

Kaudasch 1996 {published data only}
    1. Kaudasch G, Schempp P, Skierski P, Turner E. The effect of convection warming during abdominal surgery on the early postoperative heat balance. Der Anaesthesist 1996;45(11):1075‐81. - PubMed
Leben 1997 {published data only}
    1. Leben J, Tryba M. Prevention of hypothermia during surgery. Contribution of convective heating system and warm infusion. Annals of the New York Academy of Sciences 1997;813:807‐11. - PubMed
Xu 2004 {published data only}
    1. Xu L, Zhao J, Huang YG, Luo AL. The effect of intraoperative warming on patient core temperature. Chung‐Hua Wai Ko Tsa Chih 2004;42(16):1010‐3. - PubMed

Additional references

Alderson 2014
    1. Alderson P, Campbell G, Smith AF, Warttig S, Nicholson A, Lewis SR. Thermal insulation for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews 2014, Issue 6. [DOI: 10.1002/14651858.CD009908.pub2] - DOI - PMC - PubMed
Birch 2011
    1. Birch DW, Manouchehri N, Shi X, Hadi G, Karmali S. Heated CO2 with or without humidification for minimally invasive abdominal surgery. Cochrane Database of Systematic Reviews 2011, Issue 1. [DOI: 10.1002/14651858.CD007821.pub2] - DOI - PubMed
Bush 1995
    1. Bush HL Jr, Hydo LJ, Fischer E, Fantini GA, Silane MF, Barie PS. Hypothermia during elective abdominal aortic aneurysm repair: the high price of avoidable morbidity. Journal of Vascular Surgery 1995;21(3):392‐400. [PUBMED: 7877221] - PubMed
Campbell 2015
    1. Campbell G, Alderson P, Smith AF, Warttig S. Warming of intravenous and irrigation fluids for preventing inadvertent perioperative hypothermia. Cochrane Database of Systematic Reviews 2015, Issue 4. [DOI: 10.1002/14651858.CD009891.pub2] - DOI - PMC - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. [PUBMED: 18436948] - PMC - PubMed
Heier 1991
    1. Heier T, Caldwell JE, Sessler DI, Miller RD. Mild intraoperative hypothermia increases duration of action and spontaneous recovery of vecuronium blockade during nitrous oxide‐isoflurane anesthesia in humans. Anesthesiology 1991;74:815‐9. [PUBMED: 1673591] - PubMed
Heier 2006
    1. Heier T, Caldwell JE. Impact of hypothermia on the response to neuromuscular blocking drugs. Anesthesiology 2006;104(5):1070‐80. [PUBMED: 16645461] - PubMed
Higgins 2002
    1. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21(11):1539‐58. [PUBMED: 12111919] - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hoffmann 2014
    1. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. - PubMed
Leslie 1995
    1. Leslie K, Sessler DI, Bjorksten AR, Moayeri A. Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium. Anesthesia and Analgesia 1995;80(5):1007‐14. [PUBMED: 7726398] - PubMed
Lewis 2015
    1. Lewis SR, Nicholson A, Smith AF, Alderson P. Alpha‐2 adrenergic agonists for the prevention of shivering following general anaesthesia. Cochrane Database of Systematic Reviews 2015, Issue 8. [DOI: 10.1002/14651858.CD011107.pub2] - DOI - PMC - PubMed
Negishi 2003
    1. Negishi C, Hasegawa K, Mukai S, Nakagawa F, Ozaki M, Sessler DI. Resistive‐heating and forced‐air warming are comparably effective. Anesthesia and Analgesia 2003;96(6):1683‐7. - PubMed
NICE 2008
    1. National Institute for Health and Clinical Excellence. Hypothermia: prevention and management in adults having surgery. www.nice.org.uk/guidance/cg65 (Accessed 7th April 2016). - PubMed
Putzu 2007
    1. Putzu M, Casati A, Berti M, Pagliarini G, Fanelli G. Clinical complications, monitoring and management of perioperative mild hypothermia: anesthesiological features. Acta Biomedica 2007;78(3):163‐9. [PUBMED: 18330074] - PubMed
Rajagopalan 2008
    1. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology 2008;108(1):71‐7. [PUBMED: 18156884] - PubMed
Revman 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Schulz 2010
    1. Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010 2010;340:c332. - PMC - PubMed
Sessler 1991
    1. Sessler DI, Rubinstein EH, Moayeri A. Physiologic responses to mild perianesthetic hypothermia in humans. Anesthesiology 1991;75:594‐610. [PUBMED: 1928769] - PubMed
Sessler 2001
    1. Sessler D. Complications and treatment of mild hypothermia. Anesthesiology 2001;95:531‐43. [PUBMED: 9148354] - PubMed
Torossian 2007
    1. Torossian A, TEMMP (Thermoregulation in Europe Monitoring and Managing PatientTemperature) Study Group. Survey on intraoperative temperature management in Europe. European Journal of Anaesthesiology 2007;24(8):668‐75. - PubMed
Warttig 2014
    1. Warttig S, Alderson P, Campbell G, Smith AF. Interventions for treating inadvertent postoperative hypothermia. Cochrane Database of Systematic Reviews 2014, Issue 11. [DOI: 10.1002/14651858.CD009892] - DOI - PMC - PubMed
WHO 2015
    1. World Health Organization. WHO guidelines for safe surgery. apps.who.int/iris/bitstream/10665/44185/1/9789241598552_eng.pdf 2008.
Wood 2014
    1. Wood AM, Moss C, Keenan A, Reed MR, Leaper DJ. Infection control hazards associated with the use of forced‐air warming in operating theatres. The Journal of Hospital Infection 2014;88(3):132‐40. - PubMed

References to other published versions of this review

Urrútia 2011
    1. Urrútia G, Roqué i Figuls M, Campos JM, Paniagua P, Cibrian Sánchez S, Maestre L, et al. Active warming systems for preventing inadvertent perioperative hypothermia in adults. Cochrane Database of Systematic Reviews 2011, Issue 3. [DOI: 10.1002/14651858.CD009016] - DOI - PMC - PubMed

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