Evidence map›Paper›PMID 40504847›Full record

Trial reportPloS one2025

The optimal warming strategy to reduce perioperative hypothermia: A prospective randomized non-blinded clinical trial.

Ronak Desai, Jason Gosschalk, Noud van Helmond, Ludmil Mitrev, Catherine Zhang, Brian McEniry, Krystal Hunter, Ernest Wallace, Michele Mele, Jennifer Ocbo and 5 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Ronak DesaiCooper Medical School of Rowan University, Camden, New Jersey, United States of America.ORCID https://orcid.org/0009-0002-2604-117X
Jason GosschalkCooper Medical School of Rowan University, Camden, New Jersey, United States of America.ORCID https://orcid.org/0009-0004-3101-2052
Noud van HelmondCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Ludmil MitrevCooper Medical School of Rowan University, Camden, New Jersey, United States of America.ORCID https://orcid.org/0000-0002-6261-9816
Catherine ZhangCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Brian McEniryCooper University Hospital, Camden, New Jersey, United States of America.
Krystal HunterCooper University Hospital, Camden, New Jersey, United States of America.
Ernest WallaceCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Michele MeleCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Jennifer OcboCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Keyur TrivediCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
George HsuCooper Medical School of Rowan University, Camden, New Jersey, United States of America.
Sandeep KrishnanDepartment of Anesthesiology, Wayne State University School of Medicine, Pontiac, Michigan, United States of America.
John DibatoCooper University Hospital, Camden, New Jersey, United States of America.
Kinjal PatelCooper Medical School of Rowan University, Camden, New Jersey, United States of America.ORCID https://orcid.org/0000-0002-2481-1997

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo mitigate perioperative hypothermia, patients can be warmed preoperatively and intraoperatively with forced-air warming (FAW) and conductive warming (CW) methods. We examined the association of four combinations of pre- and intraoperative CW and FAW with the magnitude of intraoperative hypothermia.

methodsWe conducted a prospective randomized trial at a tertiary healthcare center in the United States (trial registration number ISRCTN23065394). Patients were randomized to 4 arms based on the following pre/intraoperative warming combinations: (1) CW/CW, (2) FAW/FAW, (3) no active prewarming (NAPW)/CW, (4) NAPW/FAW. Body temperature was measured using an esophageal probe. The area under the temperature curve (AUC) below 36°C was calculated according to the trapezoidal rule and quantified intraoperative hypothermia. A mixed model was used to estimate differences in AUC between the 4 arms.

results182 patients were analyzed. Patients in the NAPW/FAW arm had the highest AUC values while those in the CW/CW arm had the lowest. AUC values [median (Q1, Q3] were as follows: CW/CW = 4.7 (0, 26.6); FAW/FAW = 8.0 (0, 30.8); NAPW/CW = 7.4 (0, 27.1); NAPW/FAW = 19.9 (5.0, 44.3). Mixed model results showed significant lower AUC values in CW/CW and NAPW/CW when compared to NAPW/FAW. The ratio of mean AUC [95% CI] between CW/CW vs NAPW/FAW was 0.49 [0.24, 0.98], 51% lower, and between NAPW/CW and NAPW/FAW, 0.46 [0.23, 0.91], 54% lower. When the AUC was normalized to the duration of surgery (AUC/case duration in°C, or "relative AUC"), significant lower relative AUC values were observed between FAW/FAW vs NAPW/FAW (48% lower, p = 0.0419) and NAPW/CW vs NAPW/FAW (48% lower, p = 0.0407).

conclusionsCW is more effective than FAW at reducing intraoperative hypothermia when FAW is used without prewarming. When patients are actively prewarmed, CW and FAW show no difference in their ability to maintain patient temperature.

Indexed as

HypothermiaPerioperative CareAdultAgedBody TemperatureFemaleHumansMaleMiddle AgedPerioperative PeriodProspective Studies

Identifiers

PMID40504847
PMCPMC12161556

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.