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      Self-warming blankets versus active warming by forced-air devices for preventing hypothermia: A systematic review and meta-analysis

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          Background:

          Unintended perioperative hypothermia is a significant complication for patients undergoing anesthesia. Different measures are routinely undertaken to prevent hypothermia and its consequences. The evidence comparing the impact of self-warming blankets and forced-air warming is scarce. Therefore, this meta-analysis aimed to evaluate the efficacy of self-warming blankets compared to forced-air devices regarding the incidence of perioperative hypothermia.

          Methods:

          We searched the Web of Science, Cochrane Central Register of Controlled Trials, PubMed, and Scopus for relevant studies from inception until December 2022. We included comparative studies with patients allocated to undergo warming using a self-warming blanket or forced air warming. All concerned outcomes were pooled as odds ratios or mean differences (MDs) in the meta-analysis models using Review Manager (RevMan version 5.4).

          Results:

          Our results from 8 studies (597 patients) favored self-warming blankets over forced-air devices in terms of core temperature at 120 and 180 minutes after induction of general anesthesia (MD = 0.33, 95% confidence interval [CI] [0.14–0.51], P = .0006), (MD = 0.62, 95% CI [0.09–1.14], P = .02), respectively. However, the overall effect did not favor either of the 2 groups for the incidence of hypothermia (odds ratio = 0.69, 95% CI [0.18–2.62]).

          Conclusion:

          Ultimately, self-warming blankets have a more significant effect than forced-air warming systems in terms of maintaining normothermia of core temperature after induction anesthesia. However, the present evidence is not enough to verify the efficacy of the 2 warming techniques in the incidence of hypothermia. Further studies with large sample sizes are recommended.

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          Most cited references35

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            RoB 2: a revised tool for assessing risk of bias in randomised trials

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              Temperature monitoring and perioperative thermoregulation.

              Most clinically available thermometers accurately report the temperature of whatever tissue is being measured. The difficulty is that no reliably core-temperature-measuring sites are completely noninvasive and easy to use-especially in patients not undergoing general anesthesia. Nonetheless, temperature can be reliably measured in most patients. Body temperature should be measured in patients undergoing general anesthesia exceeding 30 min in duration and in patients undergoing major operations during neuraxial anesthesia. Core body temperature is normally tightly regulated. All general anesthetics produce a profound dose-dependent reduction in the core temperature, triggering cold defenses, including arteriovenous shunt vasoconstriction and shivering. Anesthetic-induced impairment of normal thermoregulatory control, with the resulting core-to-peripheral redistribution of body heat, is the primary cause of hypothermia in most patients. Neuraxial anesthesia also impairs thermoregulatory control, although to a lesser extent than does general anesthesia. Prolonged epidural analgesia is associated with hyperthermia whose cause remains unknown.
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                Author and article information

                Contributors
                Journal
                Medicine (Baltimore)
                MD
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                05 May 2023
                05 May 2023
                : 102
                : 18
                : e33579
                Affiliations
                [a ] Medical Research Group of Egypt, Cairo, Egypt
                [b ] Faculty of Medicine, Fayoum University, Fayoum, Egypt
                [c ] Faculty of Medicine, Al-Azhar University, Cairo, Egypt
                [d ] Faculty of Medicine, Zagazig University, Zagazig, Egypt
                [e ] Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, Algeria
                [f ] Faculty of Medicine, Elrazi University, Khartoum, Sudan.
                Author notes
                * Correspondence: Abdulrhman Khaity, Faculty of Medicine, Elrazi University, Khartoum 11115, Sudan (e-mail: abdulrhman.marwan.khaity@ 123456gmail.com ).
                Author information
                https://orcid.org/0000-0002-0084-6132
                Article
                00022
                10.1097/MD.0000000000033579
                10158888
                37145005
                e3ffdf19-a52e-4a5f-b3d9-f5b68f526491
                Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

                History
                : 22 January 2023
                : 28 March 2023
                : 30 March 2023
                Categories
                3300
                Research Article
                Systematic Review and Meta-Analysis
                Custom metadata
                TRUE

                air warming,hypothermia/self,warming blankets/forced

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