{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:17:44Z","timestamp":1790194664602,"version":"4.1.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Prewarming has been recommended to reduce intraoperative hypothermia. However, the evidence is unclear. This review examined if prewarming can prevent intraoperative hypothermia in patients undergoing thoracoscopic and laparoscopic surgeries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>PubMed, CENTRAL, Web of Science, and Embase databases were searched for randomized controlled trials (RCTs) up to 15<jats:sup>th<\/jats:sup> January 2024. The primary outcome of interest was the difference in intraoperative core temperature. The secondary outcomes were intraoperative hypothermia (&lt;36\u00b0) and postoperative shivering.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Seven RCTs were eligible. Meta-analysis showed that intraoperative core temperature was significantly higher at the start or within 30mins of the start of the surgery (MD: 0.32 95% CI: 0.15, 0.50 I<jats:sup>2<\/jats:sup> = 94% p = 0.0003), 60 mins after the start of the surgery (MD: 0.37 95% CI: 0.24, 0.50 I<jats:sup>2<\/jats:sup> = 81% p&lt;0.00001), 120 mins after the start of the surgery (MD: 0.34 95% CI: 0.12, 0.56 I<jats:sup>2<\/jats:sup> = 88% p = 0.003), and at the end of the surgery (MD: 0.35 95% CI: 0.25, 0.45 I<jats:sup>2<\/jats:sup> = 61% p&lt;0.00001). The incidence of shivering was also significantly lower in the prewarming group (OR: 0.18 95% CI: 0.08, 0.43 I<jats:sup>2<\/jats:sup> = 0%). Prewarming was also associated with a significant reduction in the risk of hypothermia (OR: 0.20 95% CI: 0.10, 0.41 I<jats:sup>2<\/jats:sup> = 0% p&lt;0.0001). The certainty of the evidence assessed by GRADE was \u201cmoderate\u201d for intraoperative core temperatures at all time points and \u201clow\u201d for minimal intraoperative core temperature, shivering, and hypothermia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Moderate to low-quality evidence shows that prewarming combined with intraoperative warming, as compared to intraoperative warming alone, can improve intraoperative temperature control and reduce the risk of hypothermia and shivering in patients undergoing thoracoscopic and laparoscopic procedures.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310096","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T17:39:28Z","timestamp":1726508368000},"page":"e0310096","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Comparison of prewarming plus intraoperative warming with intraoperative warming alone in patients undergoing minimally invasive thoracic or abdominal surgery: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7617-957X","authenticated-orcid":true,"given":"Ni","family":"Ding","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiying","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"pone.0310096.ref001","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1590\/S0104-11692012000100024","article-title":"Active cutaneous warming systems to prevent intraoperative hypothermia: a systematic review.","volume":"20","author":"B Poveda V de","year":"2012","journal-title":"Rev Lat Am Enfermagem"},{"key":"pone.0310096.ref002","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jopan.2021.08.013","article-title":"A Systematic Review and Meta-Analysis of Risk Factors for Unplanned Intraoperative Hypothermia Among Adult Surgical Patients.","volume":"37","author":"J Pu","year":"2022","journal-title":"J perianesthesia Nurs Off J Am Soc PeriAnesthesia Nurses."},{"key":"pone.0310096.ref003","doi-asserted-by":"crossref","first-page":"e0177221","DOI":"10.1371\/journal.pone.0177221","article-title":"Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia: National study in China.","volume":"12","author":"J Yi","year":"2017","journal-title":"PLoS One"},{"key":"pone.0310096.ref004","first-page":"8523","article-title":"The relationship between intraoperative body temperature and thiol\/disulfide balance in geriatric patients undergoing elective transurethral prostate resection surgery with spinal anesthesia","volume":"27","author":"L Kazancioglu","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"pone.0310096.ref005","first-page":"1288","article-title":"The efficacy of aggressive warming combined with tranexamic acid during total hip arthroplasty: a single-center retrospective study from southern China.","volume":"27","author":"F-L Li","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"pone.0310096.ref006","first-page":"CD009016","article-title":"Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults.","volume":"4","author":"E Madrid","year":"2016","journal-title":"Cochrane database Syst Rev."},{"key":"pone.0310096.ref007","first-page":"303","article-title":"Inadvertent Perioperative Hypothermia.","volume":"91","author":"C Garceau","year":"2023","journal-title":"AANA J"},{"key":"pone.0310096.ref008","doi-asserted-by":"crossref","first-page":"e0257816","DOI":"10.1371\/journal.pone.0257816","article-title":"Risk factors for inadvertent intraoperative hypothermia in patients undergoing laparoscopic surgery: A prospective cohort study","volume":"16","author":"H-Y Chen","year":"2021","journal-title":"PLoS One"},{"key":"pone.0310096.ref009","first-page":"9880","article-title":"Shift towards minimally invasive surgery of adnexal pathologies in children: A predictive model study","volume":"27","author":"B. 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