Effect of warm bladder irrigation fluid for benign prostatic hyperplasia patients on perioperative hypothermia, blood loss and shiver: A meta-analysis

Abstract

Objective To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia, blood loss and shiver in patients treated with benign prostatic hyperplasia (BPH). Method A comprehensive literature review and meta-analysis that included randomized controlled trials (RCTs) related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers. The relevant literature were searched in Chinese database, such as Retrieval Chinese Journal Full-text Database, VIP Journal Database, Wanfang database, as well as in English search engine and database, including Embase, Cochrane and Medline till January 2018. The study quality was assessed by recommended standards from Cochrane Handbook (version 5.1.0). Results A total of 28 RCTs and 3858 patients were included. The results showed that the incidences of shiver (risk ratio [RR] = 0.32, 95% confidence interval [CI]: 0.28–0.36, p < 0.001, I 2 = 0%) and hypothermia (RR = 0.36, 95% CI: 0.21–0.59, p < 0.001, I 2 = 67%) in the group of warm irrigation fluid were lower than the group having room-temperature fluid. Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group ( p < 0.001, I 2 = 96%). We performed a narrative descriptive statistics only because of substantial heterogeneity. Conclusions Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH. Warm irrigation fluid should be considered as a standard practice in BPH surgeries.

Effects of Irrigation Fluid Temperature During Flexible Ureteroscopic Holmium Laser Lithotripsy on Postoperative Fever and Shivering: A Randomized Controlled Trial

“…A recent meta-analysis of 28 randomized controlled trials found that the fall in body temperature during surgical treatment of benign prostatic hypertrophy and the incidence of postoperative shivering were lower for warm irrigation uid than for room-temperature irrigation uid [31]. Therefore, our ndings are in good agreement with the results of the above meta-analysis [31] and with other studies evaluating the effects of irrigation uid temperature on body temperature [32,33]. Our observation that the incidence of postoperative fever increased as the irrigation uid temperature was decreased (from 37℃ to 17℃) might be explained by a compensatory reaction of the body to hypothermia at the end of surgery, with the shivering mechanism possibly contributing to this.…”

“…By contrast, there were no cases of bleeding in the other two groups, raising the possibility that warming the irrigation uid might increase the risk of bleeding. Cao et al reported that the amount of blood lost during TURP did not differ signi cantly between warmed and room-temperature irrigation uid [31]. However, Kati et al found that the amount of blood loss during PCNL was signi cantly lower for patients irrigated with uid at room temperature [20].…”

“…Flexible ureteroscopic lithotripsy is often performed with continuous saline irrigation through the working channel to improve the visibility when an instrument is inserted, particularly during stone dusting or when a small venous bleed occurs. Warming the irrigation uid has been shown to reduce the incidence of hypothermia and shivering during transurethral resection of the prostate (TURP) [19]. Furthermore, the use of isothermic irrigation uid can help to maintain normal body temperature and avoid hypothermia during percutaneous nephrolithotripsy (PCNL) [20].…”

Impact of CRP on continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

“…In grade II, III, and all IV of HC patients related to HSCT, CBI is suggested to prevent large blood clotting in bladder forming and lower urinary tract obstruction to allow adequate catheter drainage. Although adjusting the speed of bladder saline irrigation can avoid the failure of CBI, medical nursing providers always slow down the speed of irrigation in any grades of HC patients for various reasons limiting CBI prophylactic value, such as hypothermia [4,6]. Notably, if CBI failure was not resolved in time and CBI was not suspended, iatrogenic rupture of the bladder or renal function damage could be caused.…”

Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation

“…In grade II, III, and all IV of HC patients related to HSCT, CBI is suggested to prevent large blood clotting in bladder forming and lower urinary tract obstruction to allow adequate catheter drainage. Although adjusting the speed of bladder saline irrigation dependent on the color of the drainage from the catheter can avoid the failure of CBI to some extent [7], medical nursing providers always slow down the speed of irrigation in any grades of HC patients for various reasons limiting CBI prophylactic value, such as hypothermia [4,8]. Notably, if CBI failure was not resolved in time and CBI was not suspended, iatrogenic rupture of the bladder or renal function damage could be caused.…”