Browse > Article
http://dx.doi.org/10.7739/jkafn.2017.24.3.167

Effectiveness of Active Warming Intervention for Women Undergoing Cesarean Section: A Systematic Review and Meta-analysis  

Choi, Jung Eun (Graduate School, College of Nursing, Korea University)
Kim, Mee Sun (Department of Nursing, Korea University Anam Hospital)
Song, Jin Ran (Department of Nursing, Korea University Anam Hospital)
Publication Information
Journal of Korean Academy of Fundamentals of Nursing / v.24, no.3, 2017 , pp. 167-180 More about this Journal
Abstract
Purpose: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. Methods: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. Results: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). Conclusion: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.
Keywords
Cesarean section; Hypothermia; Temperature; Shivering; Review;
Citations & Related Records
연도 인용수 순위
  • Reference
1 National Institute for Health and Care Excellence. Clinical practice guideline: The management of inadvertent perioperative hypothermia in adults [Internet]. UK: National Collaborating Centre for Nursing and Supportive Care commissioned by National Institute for Health and Clinical Excellence (NICE); 2008 [cited 2017 May 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK53788/
2 Kumar S, Wong PF, Melling AC, Leaper DJ. Effects of perioperative hypothermia and warming in surgical practice. International Wound Journal. 2005;2(3):193-204. https://doi.org/10.1111/j.1742-4801.2005.00102.x   DOI
3 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):627-631. https://doi.org/10.1093/bja/aen272   DOI
4 Health Insurance Review & Assessment Service. Clinical quality indicators: Percentage of patients maintaining normal body temperature during and after surgery [Internet]. Korea: Health Insurance Review & Assessment Service; 2014 [cited 2017 May 18]. Available from: http://www.hira.or.kr/re/invst/getInvstInfo.do?pgmid=HIRAA030085000000.
5 John M, Ford J, Harper M. Peri-operative warming devices: Performance and clinical application. Anaesthesia. 2014;69(6): 623-638. https://doi.org/10.1111/anae.12626   DOI
6 Hooper VD, Chard R, Clifford T, Fetzer S, Fossum S, Godden B, et al. ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia: Second edition. Journal of Perianesthesia Nursing. 2010;25(6):346-365. https://doi.org/10.1016/j.jopan.2010.10.006   DOI
7 AORN Recommended Practices Committee. Recommended practices for the prevention of unplanned perioperative hypothermia. Association of Perioperative Registered Nurses Journal. 2007;85(5):986-988. https://doi.org/10.1016/j.aorn.2007.04.015
8 Petsas A, Vollmer H, Barnes R. Peri-operative warming in caesarean sections. Anaesthesia. 2009;64(8):921-922. https://doi.org/10.1111/j.1365-2044.2009.06026.x   DOI
9 Butwick AJ, Lipman SS, Carvalho B. Intraoperative forced airwarming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. Anesthesia and Analgesia. 2007;105(5):1413-1419. https://doi.org/10.1213/01.ane.0000286167.96410.27   DOI
10 Sultan P, Habib AS, Cho Y, Carvalho B. The effect of patient warming during caesarean delivery on maternal and neonatal outcomes: A meta-analysis. British Journal of Anaesthesia. 2015;115(4):500-510. https://doi.org/10.1093/bja/aev325   DOI
11 Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. The Cochrane Collaboration; 2011. https://handbook.cochrane.org
12 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):309-316. https://doi.org/10.1016/j.ijoa.2014.06.003   DOI
13 Chan VW, Morley-Forster PK, Vosu HA. Temperature changes and shivering after epidural anesthesia for cesarean section. Regional Anesthesia. 1989;14(1):48-52.
14 Munday J, Hines S, Wallace K, Chang AM, Gibbons K, Yates P. A systematic review of the effectiveness of warming interventions for women undergoing cesarean section. Worldviews on Evidence-based Nursing. 2014;11(6):383-393. https://doi.org/10.1111/wvn.12067   DOI
15 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):454-460. https://doi.org/10.4097/kjae.2012.62.5.454   DOI
16 Cobb B, Cho Y, Hilton G, Ting V, Carvalho B. Active warming utilizing combined IV fluid and forced-air warming decreases hypothermia and improves maternal comfort during cesarean delivery: A randomized control trial. Anesthesia and Analgesia. 2016;122(5):1490-1497. https://doi.org/10.1213/ANE.0000000000001181   DOI
17 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):324-331. https://doi.org/10.1111/j.1552-6909.2006.00052.x   DOI
18 Yokoyama K, Suzuki M, Shimada Y, Matsushima T, Bito H, Sakamoto A. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for cesarean delivery. Journal of Clinical Anesthesia. 2009;21(4):242-248. https://doi.org/10.1016/j.jclinane.2008.12.010   DOI
19 Goyal P, Kundra S, Sharma S, Grewal A, Kaul TK, Singh MR. Efficacy of intravenous fluid warming for maintenance of core temperature during lower segment cesarean section under spinal anesthesia. Journal of Obstetric Anaesthesia and Critical Care. 2011;1(2):73-77. https://doi.org/10.4103/2249-4472.93990   DOI
20 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, and Neonatal Nursing. 2014;43(6):719-728. https://doi.org/10.1111/1552-6909.12510   DOI
21 Woolnough M, Allam J, Hemingway C, Cox M, Yentis SM. Intra-operative fluid warming in elective caesarean section: A blinded randomised controlled trial. International Journal of Obstetric Anesthesia. 2009;18(4):346-351. https://doi.org/10.1016/j.ijoa.2009.02.009   DOI
22 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):409-414. https://doi.org/10.1213/00000539-200202000-00034   DOI
23 Oshvandi K, Shiri FH, Fazel MR, Safari M, Ravari A. The effect of pre-warmed intravenous fluids on prevention of intraoperative hypothermia in cesarean section. Iranian Journal of Nursing and Midwifery Research. 2014;19(1):64-69.
24 Grant EN, Craig MG, Tao W, McIntire DD, Leveno KJ. Active warming during cesarean delivery: Should we SCIP it? American Journal of Perinatology. 2015;32(10):933-938. https://doi.org/10.1055/s-0034-1543986   DOI
25 Smith CE, Fisgus JR, Kan M, Lengen SK. Efficacy of IV fluid warming in cesarean section patients undergoing regional anesthesia. Anesthesiology. 1999;91(3A):U437.
26 John M, Ford J, Harper M. Peri-operative warming devices: Performance and clinical application. Anaesthesia. 2014;69(6): 623-638. https://doi.org/10.1111/anae.12626   DOI
27 Wrench IJ, Singh P, Dennis AR, Mahajan RP, Crossley AW. The minimum effective doses of pethidine and doxapram in the treatment of post-anaesthetic shivering. Anaesthesia. 1997;52(1):32-36. https://doi.org/10.1111/j.1365-2044.1997.006-az006.x   DOI
28 Mori R, Khanna R, Pledge D, Nakayama T. Meta-analysis of physiological effects of skin-to-skin contact for newborns and mothers. Pediatrics International. 2010;52(2):161-170. https://doi.org/10.1111/j.1442-200X.2009.02909.x   DOI
29 Sessler DI, Moayeri A. Skin-surface warming: Heat flux and central temperature. Anesthesiology. 1990;73(2):218-224.   DOI
30 Shaw CA, Steelman VM, DeBerg J, Schweizer ML. Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials. Journal of Clinical Anesthesia. 2017;38:93-104. https://doi.org/10.1016/j.jclinane.2017.01.005   DOI