Forced-air warming and continuous core temperature monitoring with zero-heat-flux thermometry during cesarean section: a retrospective observational cohort study

Marin, Laurentiu; Höcker, Jan; Esser, André; Terhorst, Rainer; Sauerwald, Axel; Schröder, Stefan

doi:10.1016/j.bjane.2021.10.007

Cited by 2 publications

(2 citation statements)

References 35 publications

(41 reference statements)

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“…2 Hypothermia in women undergoing CD, has been studied previously in randomized controlled trials (RCTs) comparing various measures of active and passive warming 10,11 and in retrospective observational studies. 12,13 In one previous RCT, the incidences of hypothermia in women undergoing CD were 64% in the group receiving active warming compared to 91% in the control group. 8 In most published studies on CD and hypothermia, the temperatures have been measured with methods that do not accurately obtain the patient's core temperature.…”

Section: Introductionmentioning

confidence: 99%

“…Spinal anaesthesia causes redistribution of blood in the area of the block from the core to peripheral tissues, although less than the full body effects of general anaesthesia induction 2 . Hypothermia in women undergoing CD, has been studied previously in randomized controlled trials (RCTs) comparing various measures of active and passive warming 10,11 and in retrospective observational studies 12,13 . In one previous RCT, the incidences of hypothermia in women undergoing CD were 64% in the group receiving active warming compared to 91% in the control group 8 …”

Section: Introductionmentioning

confidence: 99%

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Maternal hypothermia during elective caesarean delivery: A prospective observational study

Brodshaug,

Reine,

Raeder

2023

Acta Anaesthesiol Scand

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BackgroundPatients undergoing caesarean delivery are at risk of developing unintended perioperative hypothermia, defined as a core temperature <36.0°C. Most previous studies of core temperature in caesarean delivery patients have not been conducted with accurate measurements for the complete perioperative period. Therefore, we conducted a prospective observational study to identify the incidence and duration of pre‐ and post‐operative maternal hypothermia with a high accuracy continuous temperature monitoring system.MethodsWomen ≥18 years old presenting for elective caesarean delivery under spinal anaesthesia were invited to participate in the study. The primary outcomes were the incidence and duration of perioperative maternal hypothermia (<36.0°C). Maternal core temperatures were measured with the non‐invasive zero‐heat‐flux thermometer (Bair Hugger Temperature Monitoring System, 3M) throughout the perioperative course.ResultsA total of 40 participants were recruited to the study. The incidence of perioperative hypothermia was 32.5%, with a duration of 77 ± 40 min (mean ± standard deviation). The hypothermic patients had similar core temperature as the normothermic patients at baseline preoperatively, but significantly lower temperature at operating room arrival and during the remaining study period. Forty percent of all patients reported thermal discomfort and felt cold on admission to post anaesthesia care unit, whereas 33% had shivering. Neither thermal discomfort nor shivering were associated with hypothermia.ConclusionIn the present study almost a third of the women undergoing elective caesarean delivery developed perioperative hypothermia with a core temperature <36.0°C. The mean duration of maternal hypothermia was 77 min, lasting well into the postoperative period for many patients. These data should remind healthcare professionals of the importance of measuring core temperature in all phases of the perioperative setting and to consider optimal warming measures to avoid and treat hypothermia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal hypothermia during elective caesarean delivery: A prospective observational study

Brodshaug,

Reine,

Raeder

2023

Acta Anaesthesiol Scand

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Agreement between three noninvasive temperature monitoring devices during spinal anaesthesia for caesarean delivery: a prospective observational study

Vawda,

King,

Toit

et al. 2024

J Clin Monit Comput

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Hypothermia during obstetric spinal anaesthesia is a common and important problem, yet temperature monitoring is often not performed due to the lack of a suitable, cost-effective monitor. This study aimed to compare a noninvasive core temperature monitor with two readily available peripheral temperature monitors during obstetric spinal anaesthesia. We undertook a prospective observational study including elective and emergency caesarean deliveries, to determine the agreement between affordable reusable surface temperature monitors (Welch Allyn SureTemp® Plus oral thermometer and the Braun 3-in-1 No Touch infrared thermometer) and the Dräger T-core© (using dual-sensor heat flux technology), in detecting thermoregulatory changes during obstetric spinal anaesthesia. Predetermined clinically relevant limits of agreement (LOA) were set at ± 0.5 °C. We included 166 patients in our analysis. Hypothermia (heat flux temperature < 36 °C) occurred in 67% (95% CI 49 to 78%). There was poor agreement between devices. In the Bland-Altman analysis, LOA for the heat flux monitor vs. oral thermometer were 1.8 °C (CI 1.7 to 2.0 °C; bias 0.5 °C), for heat flux monitor vs. infrared thermometer LOA were 2.3 °C (CI 2.1 to 2.4 °C; bias 0.4 °C) and for infrared vs. oral thermometer, LOA were 2.0 °C (CI 1.9 to 2.2 °C; bias 0.1 °C). Error grid analysis highlighted a large amount of clinical disagreement between methods. While monitoring of core temperature during obstetric spinal anaesthesia is clinically important, agreement between monitors was below clinically acceptable limits. Future research with gold-standard temperature monitors and exploration of causes of sensor divergence is needed.

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Forced-air warming and continuous core temperature monitoring with zero-heat-flux thermometry during cesarean section: a retrospective observational cohort study

Cited by 2 publications

References 35 publications

Maternal hypothermia during elective caesarean delivery: A prospective observational study

Maternal hypothermia during elective caesarean delivery: A prospective observational study

Agreement between three noninvasive temperature monitoring devices during spinal anaesthesia for caesarean delivery: a prospective observational study

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