自热毯与强制空气设备主动加热预防低体温症的比较:系统评价和荟萃分析。

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

机构信息

Medical Research Group of Egypt, Cairo, Egypt.

Faculty of Medicine, Fayoum University, Fayoum, Egypt.

出版信息

Medicine (Baltimore). 2023 May 5;102(18):e33579. doi: 10.1097/MD.0000000000033579.

Abstract

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.

摘要

背景

围手术期意外低体温是接受麻醉的患者的一种严重并发症。常规采取不同措施预防低体温及其后果。比较自热毯和强制空气加热影响的证据很少。因此,本荟萃分析旨在评估与强制空气设备相比,自热毯在预防围手术期低体温方面的效果。

方法

我们从开始到 2022 年 12 月在 Web of Science、Cochrane 对照试验中心注册库、PubMed 和 Scopus 中搜索相关研究。我们纳入了将患者分配到使用自热毯或强制空气加热进行保暖的比较研究。所有相关结局均在荟萃分析模型中使用 Review Manager(RevMan 版本 5.4)汇总为比值比或均数差值(MD)。

结果

我们的 8 项研究(597 名患者)结果表明,与强制空气设备相比,自热毯在全麻诱导后 120 和 180 分钟时核心体温更有优势(MD=0.33,95%置信区间[CI] [0.14-0.51],P=.0006),(MD=0.62,95% CI [0.09-1.14],P=.02)。然而,整体效果并不支持两组在低体温发生率方面(比值比=0.69,95% CI [0.18-2.62])。

结论

最终,自热毯在全麻诱导后维持核心体温正常方面比强制空气加热系统效果更显著。然而,目前的证据不足以证明这两种保暖技术在低体温发生率方面的疗效。建议开展具有更大样本量的进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac31/10158888/4bcae2f7653d/medi-102-e33579-g001.jpg

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