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Effectiveness of application of carbon-fibre polymer-fabric resistive heating compared with Forced-air warming to prevent unintentional intraoperative hypothermia in patients undergoing elective abdominal operations: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND
Unintentional intraoperative hypothermia was regarded as a common intraoperative symptom with serious complications. The active warming strategies of forced-air warming and carbon-fibre polymer-fabric resistive heating was considered to be effective interventions for preventing hypothermia. However, the effectiveness of them was not reported consistently.


AIM
To evaluate the effectiveness of carbon-fibre polymer-fabric resistive heating compared with forced-air warming in preventing hypothermia in patients undergoing elective surgeries.


DESIGN
Systematic review and meta-analysis METHODS: A rigorous systematic review was conducted according to the PRISMA reporting checklist. Searching strategy was undertaken on the electronic databases of Cumulative Index to Nursing and Allied Health Literature, Medline, PubMed, Embase and Medical Literature Retrieval Service. The assessment of study quality was performed through risk of bias of Cochrane handbook of systematic review of interventions. Data synthesis was conducted through meta-analysis with sensitive analysis. The quality of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation approach.


RESULTS
A total of five randomized controlled trials with 282 patients undergoing elective surgeries were included in the quantitative synthesis. Four studies concluded that forced-air warming was as effective as carbon-fibre polymer-fabric resistive heating in preventing hypothermia. However, one study yielded a different conclusion that the efficacy of forced-air warming was superior to carbon-fibre polymer-fabric resistive heating with small incidence of hypothermia. Meta-analysis found that forced-air warming was more effective than carbon-fibre polymer-fabric resistive heating in preventing hypothermia.


CONCLUSIONS
In the elective abdominal surgery, carbon-fibre polymer-fabric resistive heating was less effective than forced-air warming on the prevention of hypothermia. However, hypothermia still occurred in the forced-air warming group. It was more objective to assess the efficacy of warming technology combining the incidence of hypothermia and the core body temperature together, which was suggested for further research.