The contribution of systematic reviews to the practice of pediatric nephrology

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

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.

Evidence-based health care in pediatrics

This article examines current trends in the type and quality of systematic reviews underpinning the evidence base for pediatric health care. A case study is used to highlight the quality standards for the conduct and publication of systematic reviews and the processes being used to transition the evidence produced from systematic reviews into the everyday systems and processes of care.