scholarly journals Preoperative Forced-Air Warming of Patients to Minimize Inadvertent Perioperative Hypothermia: A Systematic Review

2017 ◽  
Author(s):  
Devin Sadlers
Keyword(s):  
Systematic Review ◽  
Health Care Providers ◽  
Perioperative Period ◽  
Surgical Patients ◽  
Care Providers ◽  
Impaired Wound Healing ◽  
Perioperative Hypothermia ◽  
Forced Air Warming ◽  
Increased Risk ◽  
Forced Air

Inadvertent perioperative hypothermia (IPH) occurs in many patients during surgery and can potentially carry serious complications, including cardiac arrhythmia, myocardial infarction, increased bleeding, impaired drug metabolism, impaired wound healing and increased risk of wound infection. There are many different techniques to minimize hypothermia during the perioperative period, but forced-air warming is used for many surgical patients. Forced-air warming has been shown to be effective during the intraoperative period; however, many institutions do not utilize this therapy in the preoperative setting. A systematic review was conducted to assess the use of preoperative forced-air warming and its’ effects on minimizing IPH. Databases were searched for pertinent articles regarding the topic of study. Inclusion and exclusion criteria were used to finalize the articles to be included in the systematic review. A total of six studies were critically analyzed. Overall, forced-air prewarming of patients undergoing surgery helped to minimize IPH in adult surgical patients undergoing general anesthesia. Even in studies that did not demonstrate statistically significant results, findings demonstrated that patients that were preoperatively forced-air warmed were less hypothermic than those not prewarmed. Maintaining intraoperative forced-air warming, educating other health care providers about the effects of IPH, and advocating for preoperative warming are important topics that the advanced practice nurse, particularly the CRNA, can lead.

Effects of Mild Perioperative Hypothermia on Cellular Immune Responses 

1998 ◽  
Vol 89 (5) ◽  
pp. 1133-1140 ◽  
Author(s):  
Benzion Beilin ◽  
Yehuda Shavit ◽  
Jacob Razumovsky ◽  
Yaacov Wolloch ◽  
Alexander Zeidel ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Mild Hypothermia ◽  
Perioperative Period ◽  
Body Core Temperature ◽  
Tnf Alpha ◽  
Anesthetic Care ◽  
Impaired Wound Healing ◽  
Perioperative Hypothermia ◽  
Forced Air Warming ◽  
Immune Alterations

Background Unintentional perioperative hypothermia is a common complication of anesthesia and surgery associated with adverse effects on several systems, including impaired wound healing and more frequent wound infections. Mild hypothermia affects various immune functions. In the current study, the authors sought to determine whether immune alterations in the perioperative period might be induced, at least in part, by impaired thermoregulation during this period. Methods Sixty patients undergoing abdominal surgery were randomly assigned to two thermal care groups: routine care or forced-air warming. The patients' anesthetic care was standardized. Venous blood samples were collected 90 min before induction of anesthesia and immediately, 24 h, and 48 h after surgery. White cells were separated and frozen. Peripheral blood mononuclear cells were used to test cytokine production (interleukins [IL] -1beta, -2, and -6; tumor necrosis factor-alpha [TNF-alpha]), mitogens-induced proliferation, and natural killer NK cell cytotoxicity. Plasma cortisol levels were also determined. Results Patients in the normothermia group maintained normal body core temperature, whereas temperature decreased by approximately 1 degree C in the hypothermia group. Mitogenic responses were suppressed in cells from patients in the hypothermia but not in the normothermia group 24 and 48 h after surgery. Proinflammatory cytokine (IL-1beta, IL-6, TNF-alpha) production increased in both groups, although the production of IL-1beta was significantly higher in the normothermia group 24 h after surgery. Production of IL-2 was suppressed in the hypothermia but not in the normothermia group at 24 h. Conclusions Mild perioperative hypothermia suppressed mitogen-induced activation of lymphocytes and reduced the production of certain cytokines, IL-1beta and IL-2, and in this way may contribute to the immune alterations observed in the perioperative period.

Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta analysis of the literature

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 6082-6082 ◽  
Author(s):  
G. Dranitsaris ◽  
M. Johnston ◽  
S. Poirier ◽  
T. Trudi Schueller ◽  
T. Savage ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Cancer Drugs ◽  
Increased Risk

scholarly journals Effect of Preterm Birth on the Risk of Adverse Perinatal and Neonatal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 58 ◽  
pp. 004695802110641
Author(s):  
Melaku Desta ◽  
Melaku Admas ◽  
Yordanos Yeshitila ◽  
Belsity Meselu ◽  
Keralem Bishaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Neonatal Mortality ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Group Analysis ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Care Providers ◽  
Increased Risk

Despite remarkable progress in the reduction of under-five mortality, the rate of perinatal and neonatal mortality is still high especially in developing countries. The adverse outcome associated with preterm birth is one of the major public health challenges in Africa. However, there are limited and inconsistent studies conducted on the effect of preterm birth on adverse perinatal and neonatal outcomes in Ethiopia. Therefore, this systematic review and meta-analysis aimed to investigate the association between preterm birth and its adverse perinatal and neonatal outcomes in Ethiopia. We systematically searched several electronic databases like PubMed, Web of Science, SCOPUS, CINAHL, Google Scholar, African Journals Online databases and Science Direct. All identified observational studies were included. The I 1 statistics were used to assess the heterogeneity among the studies. A random-effects model was computed to estimate the pooled effect of preterm birth on adverse perinatal and neonatal outcomes. Thirty-three studies with a total of 20 109 live births were included in the final meta-analysis. Our meta-analysis showed that preterm birth increased the odds of perinatal mortality by 10-folds [POR = 9.56 (95% CI: 5.47, 19.69)] and there was a 5.44-folds risk of stillbirth [Odds Ratio = 5.44 (95% CI: 3.57, 8.28)] among women who gave birth before 37 weeks of gestation. In addition, preterm birth was significantly associated with neonatal hypothermia [OR=3.54 (95% CI: 2.41, 5.21)], neonatal mortality [OR= 3.16 (95% CI: 1.57, 6.34). The sub-group analysis of this meta-analysis showed that there was an increased risk of neonatal sepsis [OR=2.33 (95% CI: 1.15, 4.71)] among preterm babies. Preterm births significantly increased the risk of adverse perinatal and neonatal outcomes in Ethiopia. Therefore, scale-up strategies and improving the quality of maternal and child health care providers should be an area of intervention to reduce adverse outcomes associated with preterm birth. The Federal Ministry of Health and concerned bodies should work towards the prevention of preterm birth and its adverse outcomes.

Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta-analysis of the literature

2005 ◽  
Vol 11 (2) ◽  
pp. 69-78 ◽  
Author(s):  
George Dranitsaris ◽  
Mary Johnston ◽  
Susan Poirier ◽  
Trudi Schueller ◽  
Debbie Milliken ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Cancer Drugs ◽  
Increased Risk

scholarly journals Optimal Application of Forced Air Warming to Prevent Peri-Operative Hypothermia during Abdominal Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (5) ◽  
pp. 2517
Author(s):  
Yoonyoung Lee ◽  
Kisook Kim
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Upper Body ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Forced Air Warming ◽  
Forced Air ◽  
Full Body

Patients who undergo abdominal surgery under general anesthesia develop hypothermia in 80–90% of the cases within an hour after induction of anesthesia. Side effects include shivering, bleeding, and infection at the surgical site. However, the surgical team applies forced air warming to prevent peri-operative hypothermia, but these methods are insufficient. This study aimed to confirm the optimal application method of forced air warming (FAW) intervention for the prevention of peri-operative hypothermia during abdominal surgery. A systematic review and meta-analysis were conducted to provide a synthesized and critical appraisal of the studies included. We used PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published through March 2020. Twelve studies were systematically reviewed for FAW intervention. FAW intervention effectively prevented peri-operative hypothermia among patients undergoing both open abdominal and laparoscopic surgery. Statistically significant effect size could not be confirmed in cases of only pre- or peri-operative application. The upper body was the primary application area, rather than the lower or full body. These findings could contribute detailed standards and criteria that can be effectively applied in the clinical field performing abdominal surgery.

scholarly journals Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Heidi F. A. Moossdorff-Steinhauser ◽  
Bary C. M. Berghmans ◽  
Marc E. A. Spaanderman ◽  
Esther M. J. Bols
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Case Definitions ◽  
Monthly Basis ◽  
Policy Makers ◽  
In Pregnancy

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.

scholarly journals The lived experience of people with obesity: study protocol for a systematic review and synthesis of qualitative studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Farrell ◽  
Marta Bustillo ◽  
Carel W. le Roux ◽  
Joe Nadglowski ◽  
Eva Hollmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Health Care Providers ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Care Providers ◽  
Critical Appraisal Skills ◽  
Health Complications

Abstract Background Obesity is a prevalent, complex, progressive and relapsing chronic disease characterised by abnormal or excessive body fat that impairs health and quality of life. It affects more than 650 million adults worldwide and is associated with a range of health complications. Qualitative research plays a key role in understanding patient experiences and the factors that facilitate or hinder the effectiveness of health interventions. This review aims to systematically locate, assess and synthesise qualitative studies in order to develop a more comprehensive understanding of the lived experience of people with obesity. Methods This is a protocol for a qualitative evidence synthesis of the lived experience of people with obesity. A defined search strategy will be employed in conducting a comprehensive literature search of the following databases: PubMed, Embase, PsycInfo, PsycArticles and Dimensions (from 2011 onwards). Qualitative studies focusing on the lived experience of adults with obesity (BMI >30) will be included. Two reviewers will independently screen all citations, abstracts and full-text articles and abstract data. The quality of included studies will be appraised using the critical appraisal skills programme (CASP) criteria. Thematic synthesis will be conducted on all of the included studies. Confidence in the review findings will be assessed using GRADE CERQual. Discussion The findings from this synthesis will be used to inform the EU Innovative Medicines Initiative (IMI)-funded SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) study. The objective of SOPHIA is to optimise future obesity treatment and stimulate a new narrative, understanding and vocabulary around obesity as a set of complex and chronic diseases. The findings will also be useful to health care providers and policy makers who seek to understand the experience of those with obesity. Systematic review registration PROSPERO CRD42020214560.

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