{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:34:56Z","timestamp":1793946896085,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Technology Commission of zhenhai District, Zhejiang Province","award":["RMB 40000"],"award-info":[{"award-number":["RMB 40000"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preventing the frequent perioperative hypothermia incidents that occur during elective caesarean deliveries would be beneficial. This trial aimed at evaluating the effect of preoperative forced-air warming alongside perioperative intravenous fluid warming in women undergoing cesarean sections under spinal anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We randomly allocated\u00a0135 women undergoing elective cesarean deliveries to either the intervention group (preoperative forced-air and intravenous fluid warming,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200969) or the control group (no active warming,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966). The primary outcome measure was the core temperature change between groups from baseline to the end of the surgical procedure. Secondary outcomes included thermal comfort scores, the incidences of shivering and hypothermia (&lt;\u200936\u2009\u00b0C), the core temperature on arrival at the post-anesthesia care unit, neonatal axillary temperature at birth, and Apgar scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two-way repeated measures ANOVA revealed significantly different core temperature changes (from the pre-spinal temperature to that at the end of the procedure) between groups (\n                      <jats:italic>F<\/jats:italic>\n                      \u2009=\u200913.022,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The thermal comfort scores were also higher in the intervention group than in the control group (\n                      <jats:italic>F<\/jats:italic>\n                      \u2009=\u20099.847,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). The overall incidence of perioperative hypothermia was significantly lower in the intervention group than in the control group (20.6% vs. 51.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Warming preoperative forced-air and perioperative intravenous fluids may prevent maternal hypothermia, reduce maternal shivering, and improve maternal thermal comfort for patients undergoing cesarean sections under spinal anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      The study was registered with the Chinese Clinical Trial Registry (registration number:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\/index.aspx\">ChiCTR1800019117<\/jats:ext-link>\n                      ) on October26, 2018.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-020-00970-7","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T04:03:02Z","timestamp":1582689782000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effects of combined warmed preoperative forced-air and warmed perioperative intravenous fluids on maternal temperature during cesarean section: a prospective, randomized, controlled clinical trial"],"prefix":"10.1186","volume":"20","author":[{"given":"Ting-ting","family":"Ni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-feng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-he","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"key":"970_CR1","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.jclinane.2008.12.010","volume":"21","author":"K Yokoyama","year":"2009","unstructured":"Yokoyama K, Suzuki M, Shimada Y, Matsushima T, Bito H, Sakamoto A. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for cesarean delivery. J Clin Anesth. 2009;21:242\u20138.","journal-title":"J Clin Anesth"},{"key":"970_CR2","first-page":"436","volume":"67","author":"L Carpenter","year":"2012","unstructured":"Carpenter L, Baysinger CL. Maintaining perioperative normothermia in the patient undergoing cesarean delivery. ObstetGynecolSurv. 2012;67:436\u201346.","journal-title":"ObstetGynecolSurv."},{"key":"970_CR3","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1111\/j.1365-2044.2009.06026.x","volume":"64","author":"A Petsas","year":"2009","unstructured":"Petsas A, Vollmer H, Barnes R. Peri-operative warming in caesarean sections. Anaesthesia. 2009;64:921\u20132.","journal-title":"Anaesthesia."},{"key":"970_CR4","first-page":"1413","volume":"105","author":"AJ Butwick","year":"2007","unstructured":"Butwick AJ, Lipman SS, Carvalho B. Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia. AnesthAnalg. 2007;105:1413\u20139 table of contents.","journal-title":"AnesthAnalg"},{"key":"970_CR5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/01.anes.0000296719.73450.52","volume":"108","author":"S Rajagopalan","year":"2008","unstructured":"Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108:71\u20137.","journal-title":"Anesthesiology."},{"key":"970_CR6","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1016\/S0140-6736(01)06071-8","volume":"358","author":"AC Melling","year":"2001","unstructured":"Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet. 2001;358:876\u201380.","journal-title":"Lancet."},{"key":"970_CR7","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1056\/NEJM199605093341901","volume":"334","author":"A Kurz","year":"1996","unstructured":"Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of wound infection and temperature group. N Engl J Med. 1996;334:1209\u201315.","journal-title":"N Engl J Med"},{"key":"970_CR8","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/S0188-4409(01)00272-7","volume":"32","author":"A Flores-Maldonado","year":"2001","unstructured":"Flores-Maldonado A, Medina-Escobedo CE, R\u00edos-Rodr\u00edguez HM, Fern\u00e1ndez-Dom\u00ednguez R. Mild perioperative hypothermia and the risk of wound infection. Arch Med Res. 2001;32:227\u201331.","journal-title":"Arch Med Res"},{"key":"970_CR9","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/S0140-6736(96)90466-3","volume":"347","author":"H Schmied","year":"1996","unstructured":"Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289\u201392.","journal-title":"Lancet."},{"key":"970_CR10","first-page":"259","volume":"11","author":"SR Hart","year":"2011","unstructured":"Hart SR, Bordes B, Hart J, Corsino D, Harmon D. Unintended perioperative hypothermia. Ochsner J. 2011;11:259\u201370.","journal-title":"Ochsner J"},{"key":"970_CR11","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1001\/jama.1997.03540380041029","volume":"277","author":"SM Frank","year":"1997","unstructured":"Frank SM, Fleisher LA, Breslow MJ, Higgins MS, Olson KF, Kelly S, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA. 1997;277:1127\u201334.","journal-title":"JAMA."},{"key":"970_CR12","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1016\/S1072-7515(99)00035-6","volume":"188","author":"RY Peng","year":"1999","unstructured":"Peng RY, Bongard FS. Hypothermia in trauma patients. J Am Coll Surg. 1999;188:685\u201396.","journal-title":"J Am Coll Surg"},{"key":"970_CR13","first-page":"409","volume":"94","author":"E-P Horn","year":"2002","unstructured":"Horn E-P, Schroeder F, Gottschalk A, Sessler DI, Hiltmeyer N, Standl T, et al. Active warming during cesarean delivery. AnesthAnalg. 2002;94:409\u201314 table of contents.","journal-title":"AnesthAnalg"},{"key":"970_CR14","first-page":"777","volume":"101","author":"M Suzuki","year":"2005","unstructured":"Suzuki M, Kinoshita T, Kikutani T, Yokoyama K, Inagi T, Sugimoto K, et al. Determining the plasma concentration of ketamine that enhances epiduralbupivacaine-and-morphine-induced analgesia. AnesthAnalg. 2005;101:777\u201384.","journal-title":"AnesthAnalg."},{"key":"970_CR15","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1097\/00000542-199408000-00004","volume":"81","author":"M Ozaki","year":"1994","unstructured":"Ozaki M, Kurz A, Sessler DI, Lenhardt R, Schroeder M, Moayeri A, et al. Thermoregulatory thresholds during epidural and spinal anesthesia. Anesthesiology. 1994;81:282\u20138.","journal-title":"Anesthesiology."},{"key":"970_CR16","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1097\/00000542-199511000-00008","volume":"83","author":"T Matsukawa","year":"1995","unstructured":"Matsukawa T, Sessler DI, Christensen R, Ozaki M, Schroeder M. Heat flow and distribution during epidural anesthesia. Anesthesiology. 1995;83:961\u20137.","journal-title":"Anesthesiology."},{"key":"970_CR17","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/0952-8180(92)90064-8","volume":"4","author":"JM Hynson","year":"1992","unstructured":"Hynson JM, Sessler DI. Intraoperative warming therapies: a comparison of three devices. J Clin Anesth. 1992;4:194\u20139.","journal-title":"J Clin Anesth"},{"key":"970_CR18","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1097\/00000542-199308000-00005","volume":"79","author":"JM Hynson","year":"1993","unstructured":"Hynson JM, Sessler DI, Moayeri A, McGuire J, Schroeder M. The effects of preinduction warming on temperature and blood pressure during propofol\/nitrous oxide anesthesia. Anesthesiology. 1993;79:219\u201328 discussion 21A-22A.","journal-title":"Anesthesiology"},{"key":"970_CR19","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/j.1365-2044.2005.04466.x","volume":"61","author":"C-K Hui","year":"2006","unstructured":"Hui C-K, Huang C-H, Lin C-J, Lau H-P, Chan W-H, Yeh H-M. A randomised double-blind controlled study evaluating the hypothermic effect of 150 microg morphine during spinal anaesthesia for caesarean section. Anaesthesia. 2006;61:29\u201331.","journal-title":"Anaesthesia."},{"key":"970_CR20","first-page":"997","volume":"118","author":"E-P Horn","year":"2014","unstructured":"Horn E-P, Bein B, Steinfath M, Ramaker K, Buchloh B, H\u00f6cker J. The incidence and prevention of hypothermia in newborn bonding after cesarean delivery: a randomized controlled trial. AnesthAnalg. 2014;118:997\u20131002.","journal-title":"AnesthAnalg."},{"key":"970_CR21","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/1477-7827-11-118","volume":"11","author":"A Conforti","year":"2013","unstructured":"Conforti A, Alviggi C, Mollo A, De Placido G, Magos A. The management of Asherman syndrome: a review of literature. Reprod Biol Endocrinol. 2013;11:118.","journal-title":"Reprod Biol Endocrinol"},{"key":"970_CR22","doi-asserted-by":"publisher","first-page":"3242","DOI":"10.1161\/STROKEAHA.108.523654","volume":"39","author":"N Badjatia","year":"2008","unstructured":"Badjatia N, Strongilis E, Gordon E, Prescutti M, Fernandez L, Fernandez A, et al. Metabolic impact of shivering during therapeutic temperature modulation: the bedside shivering assessment scale. Stroke. 2008;39:3242\u20137.","journal-title":"Stroke."},{"key":"970_CR23","doi-asserted-by":"publisher","first-page":"454","DOI":"10.4097\/kjae.2012.62.5.454","volume":"62","author":"SH Chung","year":"2012","unstructured":"Chung SH, Lee B-S, Yang HJ, Kweon KS, Kim H-H, Song J, et al. Effect of preoperative warming during cesarean section under spinal anesthesia. Korean J Anesthesiol. 2012;62:454\u201360.","journal-title":"Korean J Anesthesiol"},{"key":"970_CR24","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1097\/00000542-199705000-00007","volume":"86","author":"A Kurz","year":"1997","unstructured":"Kurz A, Ikeda T, Sessler DI, Larson MD, Bjorksten AR, Dechert M, et al. Meperidine decreases the shivering threshold twice as much as the vasoconstriction threshold. Anesthesiology. 1997;86:1046\u201354.","journal-title":"Anesthesiology."},{"key":"970_CR25","first-page":"1490","volume":"122","author":"B Cobb","year":"2016","unstructured":"Cobb B, Cho Y, Hilton G, Ting V, Carvalho B. Active warming utilizing combined IV fluid and forced-air warming decreases hypothermia and improves maternal comfort during cesarean delivery: a randomized control trial. AnesthAnalg. 2016;122:1490\u20137.","journal-title":"AnesthAnalg."},{"key":"970_CR26","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.bjan.2015.10.006","volume":"66","author":"RCG de Bernardis","year":"2016","unstructured":"de Bernardis RCG, Siaulys MM, Vieira JE, Mathias LAST. Perioperative warming with a thermal gown prevents maternal temperature loss during elective cesarean section. A randomized clinical trial. Braz J Anesthesiol. 2016;66:451\u20135.","journal-title":"Braz J Anesthesiol"},{"key":"970_CR27","first-page":"183","volume":"126","author":"J Munday","year":"2018","unstructured":"Munday J, Osborne S, Yates P, Sturgess D, Jones L, Gosden E. Preoperative warming versus no preoperative warming for maintenance of Normothermia in women receiving Intrathecal morphine for cesarean delivery: a single-blinded, randomized controlled trial. AnesthAnalg. 2018;126:183\u20139.","journal-title":"AnesthAnalg"},{"key":"970_CR28","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1097\/00000542-198155060-00024","volume":"55","author":"PJ Webb","year":"1981","unstructured":"Webb PJ, James FM, Wheeler AS. Shivering during epidural analgesia in women in labor. Anesthesiology. 1981;55:706\u20137.","journal-title":"Anesthesiology."},{"key":"970_CR29","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1093\/bja\/aev325","volume":"115","author":"P Sultan","year":"2015","unstructured":"Sultan P, Habib AS, Cho Y, Carvalho B. The effect of patient warming during caesarean delivery on maternal and neonatal outcomes: a meta-analysis. Br J Anaesth. 2015;115:500\u201310.","journal-title":"Br J Anaesth"},{"key":"970_CR30","first-page":"346","volume":"18","author":"M Woolnough","year":"2009","unstructured":"Woolnough M, Allam J, Hemingway C, Cox M, Yentis SM. Intra-operative fluid warming in elective caesarean section: a blinded randomised controlled trial. Int J ObstetAnesth. 2009;18:346\u201351.","journal-title":"Int J ObstetAnesth"},{"key":"970_CR31","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1111\/j.1552-6909.2006.00052.x","volume":"35","author":"WM Fallis","year":"2006","unstructured":"Fallis WM, Hamelin K, Symonds J, Wang X. Maternal and newborn outcomes related to maternal warming during cesarean delivery. J ObstetGynecol Neonatal Nurs. 2006;35:324\u201331.","journal-title":"J ObstetGynecol Neonatal Nurs"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-020-00970-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12871-020-00970-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-020-00970-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T19:11:45Z","timestamp":1614193905000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-020-00970-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,26]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["970"],"URL":"https:\/\/doi.org\/10.1186\/s12871-020-00970-7","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.20668\/v2","asserted-by":"object"},{"id-type":"doi","id":"10.21203\/rs.2.20668\/v1","asserted-by":"object"}]},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,26]]},"assertion":[{"value":"28 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the local Ethics Committee (The Ethical Committee of NingboNO.7 Hospital). Written Informed consent to participate in the study was obtained from participants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}