{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:06:43Z","timestamp":1780988803691,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Intraoperative hypothermia remains a frequent and under\u2010recognized complication in neonates undergoing surgery despite standard preventive measures. Low\u2010flow anesthesia, by increasing rebreathing and conserving heat and humidity, may offer a thermo\u2010protective effect. In this study, we compare the incidence of intraoperative hypothermia between low\u2010flow (1\u2009L\/min) vs. routine\u2010flow (2\u2009L\/min) anesthesia in neonates undergoing abdominal surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n After obtaining written informed consent from parents or legal guardians, 160 neonates scheduled for elective or emergency abdominal surgery were randomized into two groups: Group L (low\u2010flow, 1\u2009L\/min) and Group C (control, 2\u2009L\/min). Core temperature was continuously monitored intraoperatively. The primary outcome was the incidence of intraoperative hypothermia (core temperature <\u200936\u00b0C). Secondary outcomes included changes in core temperature, minimum and maximum intraoperative temperature, percentage of surgical time spent under hypothermia, time to extubation, blood loss, transfusion requirements, use of inotropes, and postoperative ventilation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The incidence of intraoperative hypothermia was significantly lower in group L compared to group C (75% vs. 90%,\n p<\/jats:italic>\n \u2009=\u20090.01). The median (IQR) drop in core temperature from baseline was smaller in group L as compared to group C [0.80\u00b0C (0.60\u20131.10) vs. 1.20\u00b0C (0.90\u20131.50),\n p<\/jats:italic>\n \u2009<\u20090.001]. Minimum core temperature was higher in group L [35.5\u00b0C (35.20\u201335.90) vs. 35\u00b0C (34.80\u201335.40),\n p<\/jats:italic>\n \u2009<\u20090.001]. The percentage of surgical time spent under hypothermia (<\u200936\u00b0C) was significantly lower in group L [50.3% (95% CI: 43.3\u201357.3)] compared to group C [65.6% (95% CI: 58.6\u201372.6),\n p<\/jats:italic>\n \u2009=\u20090.003]. While intraoperative blood loss was slightly higher in the low\u2010flow group, the clinical impact was minimal. Other outcomes, including extubation time, inotrope use, and hypoxia incidence, were comparable between groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Low\u2010flow anesthesia technique at 1\u2009L\/min is a safe and effective approach for reducing the incidence and duration of intraoperative hypothermia in neonates undergoing abdominal surgery.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n Clinical Trial Registry of India (\n www.ctri.nic.in<\/jats:ext-link>\n ): CTRI\/2022\/11\/047532\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pan.70189","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:10:05Z","timestamp":1776345005000},"page":"813-821","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Low Fresh Gas Flows on Intraoperative Hypothermia Among Neonates Undergoing Abdominal Surgeries: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"36","author":[{"given":"Manisha","family":"Chauhan","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choro Athiphro","family":"Kayina","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain Medicine and Critical Care All India Institute of Medical Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1526-5370","authenticated-orcid":false,"given":"Ajay","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkata","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3868-0473","authenticated-orcid":false,"given":"Naveen","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preethy J.","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-3383","authenticated-orcid":false,"given":"Nitin James","family":"Peter","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Essential Elements of Obstetric Care at First Referral Level","author":"World Health Organization","year":"1991"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmz086"},{"key":"e_1_2_9_4_1","unstructured":"H. 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In: Up to Dateavailable from https:\/\/www.uptodate.com\/contents\/hypothermiain\u2010children\u2010clinical\u2010manifestations\u2010and\u2010diagnosis."},{"key":"e_1_2_9_5_1","volume-title":"Thermal Protection of the Newborn: A Practical Guide","author":"World Health Organization","year":"1997"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2018.05.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18147541"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/wjps-2020-000141"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200108000-00040"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen233"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005400050050"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_413_17"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e3283414cb7"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824f6940"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-019-00259-2"},{"key":"e_1_2_9_16_1","first-page":"20","article-title":"Incidence, Risk Factors and Outcome of Perioperative Hypothermia in Pediatric Patients at the University Teaching Hospital of Kigali","volume":"77","author":"Uwimana J. 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