Liu Shuyan, Pan Yu, Zhao Qiancong, Feng Wendy, Han Hongyu, Pan Zhenxiang, Sun Qianchuang
Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
Department of Genetics, The University of Alabama at Birmingham, Birmingham, AL.
Medicine (Baltimore). 2019 May;98(19):e15630. doi: 10.1097/MD.0000000000015630.
Perioperative hypothermia is a common and serious complication during surgery. Different warming systems are used to prevent perioperative hypothermia. However, there have been no previous meta-analyses of the effectiveness of air-free warming systems on perioperative hypothermia in patients undergoing joint arthroplasty.
We systematically searched PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases to collect randomized controlled trials (RCTs) from inception to August 2018. These RCTs compared the effects of air-free warming with forced-air (FA) warming system in patients undergoing joint arthroplasty. Postoperative temperature, core temperature during surgery, thermal comfort, blood loss and incidence of shivering and hypothermia were analyzed.
A total of 287 patients from 6 clinical studies were included in the analysis. In summary, there was no significant difference in the postoperative temperature (WMD -0.043, 95% CI -0.32 to 0.23, P = .758) between the air-free warming and FA warming groups. No statistical difference (WMD 0.058, 95% CI -0.10 to 0.22, P = .475) was found in core temperatures at 0 minutes during surgery between the air-free warming and FA warming groups. Furthermore, there was no statistical difference in thermal comfort, blood loss or incidence of shivering and hypothermia between the air-free warming and FA warming groups.
Air-free warming system was as effective as FA warming system in patients undergoing joint arthroplasty.
围手术期体温过低是手术期间常见且严重的并发症。不同的保暖系统用于预防围手术期体温过低。然而，既往尚无关于无气保暖系统对接受关节置换术患者围手术期体温过低有效性的荟萃分析。
我们系统检索了PubMed、EMBASE、Cochrane图书馆和中国知网数据库，以收集从建库至2018年8月的随机对照试验（RCT）。这些RCT比较了无气保暖与强制空气（FA）保暖系统对接受关节置换术患者的影响。分析了术后体温、手术期间的核心体温、热舒适度、失血量以及寒战和体温过低的发生率。
分析纳入了来自6项临床研究的287例患者。总体而言，无气保暖组与FA保暖组之间的术后体温无显著差异（加权均数差[WMD] -0.043，95%置信区间[CI] -0.32至0.23，P = 0.758）。无气保暖组与FA保暖组在手术0分钟时的核心体温无统计学差异（WMD 0.058，95% CI -0.10至0.22，P = 0.475）。此外，无气保暖组与FA保暖组在热舒适度、失血量或寒战和体温过低的发生率方面无统计学差异。
在接受关节置换术的患者中，无气保暖系统与FA保暖系统同样有效。
