Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis
Background The application of a heated-humidified breathing circuit (HHBC) may reduce respiratory heat loss during mechanical ventilation, but its effect in preventing intraoperative hypothermia is controversial. This study aimed to investigate the effectiveness of HHBC in maintaining the core tempe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2023-02-01
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| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kja-22200.pdf |
| _version_ | 1797937948851699712 |
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| author | Je Jin Lee Geun Joo Choi Won Jun Lee Sang Bong Choi Hyun Kang |
| author_facet | Je Jin Lee Geun Joo Choi Won Jun Lee Sang Bong Choi Hyun Kang |
| author_sort | Je Jin Lee |
| collection | DOAJ |
| description | Background The application of a heated-humidified breathing circuit (HHBC) may reduce respiratory heat loss during mechanical ventilation, but its effect in preventing intraoperative hypothermia is controversial. This study aimed to investigate the effectiveness of HHBC in maintaining the core temperature of patients receiving mechanical ventilation under general anesthesia. Methods We searched MEDLINE, Embase, Cochrane library (CENTRAL), and Google Scholar to identify all randomized controlled trials (RCTs) up to February 2022 that compared the intraoperative core temperature in patients with heated humidifier (HH) and other circuit devices. The primary outcome was the intraoperative core temperature at the end of surgery. The weighted mean differences (WMDs) between the groups and their 95% CIs were calculated for each outcome. We performed a trial sequential analysis of the primary outcomes to assess whether our results were conclusive. Results Eighteen RCTs with 993 patients were included in the analysis. A significantly higher core temperature was observed at the end of surgery in patients with HH than those with no device (WMD = 0.734, 95% CI [0.443, 1.025]) or heat and moisture exchanger (WMD = 0.368, 95% CI [0.118, 0.618]), but with substantial heterogeneity. Conclusions Although HHBC did not absolutely prevent hypothermia, this meta-analysis suggests that it can be used as an effective supplemental device to maintain the intraoperative core temperature under general anesthesia. However, considering the substantial heterogeneity and limitations of this study, further well-designed studies are needed to clarify the effectiveness of HHBC. |
| first_indexed | 2024-04-10T18:53:20Z |
| format | Article |
| id | doaj.art-26b87e8854bf4cdb95a9de506fb5b3ab |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-04-10T18:53:20Z |
| publishDate | 2023-02-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-26b87e8854bf4cdb95a9de506fb5b3ab2023-02-01T05:08:01ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632023-02-01761173310.4097/kja.222008823Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysisJe Jin Lee0Geun Joo Choi1Won Jun Lee2Sang Bong Choi3Hyun Kang4 Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, KoreaBackground The application of a heated-humidified breathing circuit (HHBC) may reduce respiratory heat loss during mechanical ventilation, but its effect in preventing intraoperative hypothermia is controversial. This study aimed to investigate the effectiveness of HHBC in maintaining the core temperature of patients receiving mechanical ventilation under general anesthesia. Methods We searched MEDLINE, Embase, Cochrane library (CENTRAL), and Google Scholar to identify all randomized controlled trials (RCTs) up to February 2022 that compared the intraoperative core temperature in patients with heated humidifier (HH) and other circuit devices. The primary outcome was the intraoperative core temperature at the end of surgery. The weighted mean differences (WMDs) between the groups and their 95% CIs were calculated for each outcome. We performed a trial sequential analysis of the primary outcomes to assess whether our results were conclusive. Results Eighteen RCTs with 993 patients were included in the analysis. A significantly higher core temperature was observed at the end of surgery in patients with HH than those with no device (WMD = 0.734, 95% CI [0.443, 1.025]) or heat and moisture exchanger (WMD = 0.368, 95% CI [0.118, 0.618]), but with substantial heterogeneity. Conclusions Although HHBC did not absolutely prevent hypothermia, this meta-analysis suggests that it can be used as an effective supplemental device to maintain the intraoperative core temperature under general anesthesia. However, considering the substantial heterogeneity and limitations of this study, further well-designed studies are needed to clarify the effectiveness of HHBC.http://ekja.org/upload/pdf/kja-22200.pdfbody temperatureclosed-circuit anesthesiageneral anesthesiaheatinghypothermiameta-analysissystemaic review |
| spellingShingle | Je Jin Lee Geun Joo Choi Won Jun Lee Sang Bong Choi Hyun Kang Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis Korean Journal of Anesthesiology body temperature closed-circuit anesthesia general anesthesia heating hypothermia meta-analysis systemaic review |
| title | Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis |
| title_full | Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis |
| title_fullStr | Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis |
| title_full_unstemmed | Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis |
| title_short | Effect of active airway warming with a heated-humidified breathing circuit on core body temperature in patients under general anesthesia: a systematic review and meta-analysis with trial sequential analysis |
| title_sort | effect of active airway warming with a heated humidified breathing circuit on core body temperature in patients under general anesthesia a systematic review and meta analysis with trial sequential analysis |
| topic | body temperature closed-circuit anesthesia general anesthesia heating hypothermia meta-analysis systemaic review |
| url | http://ekja.org/upload/pdf/kja-22200.pdf |
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