Effect of Preoperative Active Warming and Passive Warming Methods on Perioperative Hypothermia
Condition: Hypothermia; Perioperative Care; Vital Signs; Rewarming
MeSH terms: Hypothermia
Study type: Interventional

Summary: 
      70% of surgical interventions are abdominal surgeries. Open abdominal surgery is performed in
      patients for whom minimally invasive approaches are not suitable. In these surgeries in which
      general anesthesia is used, the duration of the operation is longer, complications are more
      frequent, and postoperative recovery occurs later. Low body temperature before surgery,
      preoperative fasting and fluid deprivation before anesthesia, exposure of large body surface
      areas, evaporative heat loss during skin preparation using volatile solutions, large open
      cavity or abdominal surgery longer operative time and exposure to anesthesia, during surgical
      intervention excessive blood loss etc. surgical intervention poses a risk for the formation
      of undesirable hypothermia.

      Cardiovascular and respiratory system problems that may increase mortality due to hypothermia
      in surgical patients; may cause a decrease in heart rhythm, cardiac output, blood pressure
      and oxygen saturation, and an increased risk of cardiac arrest and ischemia. With the
      development of shivering, oxygen consumption increases and the "thermal comfort" of the
      patient deteriorates. The length of stay in the postoperative unit and hospital stay are
      prolonged, causing an increase in costs.

      Among the rapid recovery protocols, it is recommended to pre-warm the patients in the
      preoperative period to maintain normothermia. Many complications are prevented by different
      methods and warming procedures performed in the perioperative period.

      In our study, it was aimed to compare the effects of active and passive warming on
      hypothermia, vital signs and warmth comfort in the postoperative period in patients who will
      undergo open abdominal surgery.
    

Detailed description: 
      Before starting the research, permission was obtained from Çukurova University Medical
      Faculty Balcalı Hospital General Surgery Department Academic Committee and Operating Room
      Committee, from Balcalı Hospital Chief Physician (Annex-11), and Çukurova Ethics Committee by
      the investigator . University Faculty of Medicine Non-Interventional Research Ethics
      Committee approval was received with the date and number of 10.04.2020/98-29 An application
      was made to the Scientific Research Projects Unit to support the project with all
      permissions. It has been approved as a Scientific Research Project.

      In accordance with the results of the power analysis using the G power 3.1.9.2 program, it
      was planned to include 30 participants in the active warming group, 30 partici in the passive
      warming group and 30 participants in the control group, and a simple randomization method was
      used in the distribution. Sample for study groups Research data were collected in the
      operating room preoperative unit and postoperative unit between July 2020 and December 2020.

      When the participants came to the preoperative unit before the operation, his vital signs,
      temperature comfort perception scale and shivering level, temperature and humidity of the
      room were measured by the investigator and recorded in the Personal Information Form, Vital
      Signs Monitoring Form, Temperature Comfort Perception Scale Form, Shivering Level Diagnostic
      Form. Before anesthesia was given, one group was heated with the 3M Bair Hugger Model 775
      Heating Unit (Hot Air Blowing Warmer Blanket) with an active heating system and the other
      group with a passive heating system (wool blanket) for 20 minutes, routine application was
      made to the control group participants by the investigator . Vital signs, tremor levels and
      temperature comfort perception measurements were made at the 0th, 15th, and 30th minutes in
      the postoperative unit of the participants after the operation by the investigator .
      Statistical analyzes of the collected data were made using a package program called SPSS (IBM
      SPSS Statistics 24). Frequency tables and descriptive statistics were used to interpret the
      findings. In accordance with parametric methods, the "ANOVA" test (F-table value) was used to
      compare the measurement values of three or more independent groups, and the
      "RepeatedMeasures" test (F-Table) was used to compare the measurement values of three or more
      dependent groups. The "Mann-Whitney U" test (Z-table value) and the "Kruskal-Wallis H" test
      (χ2- table value) were used to compare the measurement values of two independent groups in
      accordance with non-parametric methods. ) method was used. "Wilcoxon" test (Z-table value) to
      compare measurement values of two dependent groups, "Friedman" test (χ2-table value) to
      compare measurement values of three or more dependent groups, "Pearson-χ2 To examine the
      relationships between two qualitative variables used "cross tables" were used.
    

Intervention name(s): Pre Heating
Intervention type(s): Procedure
Intervention description(s): Before anesthesia was given, the participants were warmed for 20 minutes with prewarming techniques. Presence of postoperative hypothermia, vital signs and temperature comfort level were evaluated.
Other intervention name(s): Pre Warming
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 3 Group randomized
Masking: Single (Participant)
Primary purpose: Prevention