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荟萃分析:强制空气加温预防手术患者围手术期低体温的有效性

Meta-analysis: effectiveness of forced-air warming for prevention of perioperative hypothermia in surgical patients.

作者信息

Nieh Hsiao-Chi, Su Shu-Fen

机构信息

Department of Nursing, Taichung Veterans General Hospital, Taiwan.

School of Nursing, Hungkuang University, Taichung City, Taiwan.

出版信息

J Adv Nurs. 2016 Oct;72(10):2294-314. doi: 10.1111/jan.13010. Epub 2016 May 31.

Abstract

AIM

The aim of this study was to evaluate the effectiveness of forced-air warming for preventing perioperative hypothermia.

BACKGROUND

Perioperative hypothermia commonly occurs in patients receiving anaesthesia during surgeries. However, the effectiveness of warming systems requires verification.

DESIGN

Systematic review incorporating meta-analysis.

DATA SOURCES

We searched OVID, PubMed, Cochrane Library, Medline, CINAHL, CETD and CEPS databases (2001-2015) for randomized controlled trials published in English and Chinese. Outcome measures of interests were body temperature and thermal comfort.

REVIEW METHODS

Cochrane methods, Quality of evidence (GRADE) assessments and Jadad Quality Score were used.

RESULTS

Twenty-nine trials (1875 patients) met inclusion criteria, including seven trials (502 patients) related to thermal comfort. Results showed that: (1) forced-air warming was more effective than passive insulation and circulating-water mattresses; (2) there was no statistically significant difference among forced-air warming, resistive heating blankets, radiant warming systems and circulating-water garments; and (3) that thermal comfort provided by forced-air warming was superior to that of passive insulation, resistive heating blankets and radiant warming systems, but inferior to that of circulating-water mattresses.

CONCLUSIONS

Forced-air warming prevents perioperative hypothermia more effectively than passive insulation and circulating-water mattresses, whereas there is no statistically significant difference in its effectiveness compared with circulating-water garments, resistive heating blankets and radiant warming systems.

摘要

目的

本研究旨在评估强制空气加温预防围手术期体温过低的有效性。

背景

围手术期体温过低常见于手术期间接受麻醉的患者。然而,加温系统的有效性需要验证。

设计

纳入荟萃分析的系统评价。

数据来源

我们检索了OVID、PubMed、Cochrane图书馆、Medline、CINAHL、CETD和CEPS数据库(2001年至2015年),以查找用英文和中文发表的随机对照试验。感兴趣的结局指标为体温和热舒适度。

综述方法

采用Cochrane方法、证据质量(GRADE)评估和Jadad质量评分。

结果

29项试验(1875例患者)符合纳入标准,其中7项试验(502例患者)与热舒适度有关。结果显示:(1)强制空气加温比被动保温和循环水床垫更有效;(2)强制空气加温、电阻加热毯、辐射加温系统和循环水衣物之间无统计学显著差异;(3)强制空气加温提供的热舒适度优于被动保温、电阻加热毯和辐射加温系统,但不如循环水床垫。

结论

强制空气加温预防围手术期体温过低比被动保温和循环水床垫更有效,而与循环水衣物、电阻加热毯和辐射加温系统相比,其有效性无统计学显著差异。

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