{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:18:25Z","timestamp":1787026705875,"version":"build-2736575974"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:00:00Z","timestamp":1640217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016112","name":"Universit\u00e0 degli Studi di Foggia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016112","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Perioperative hypothermia (body temperature &amp;lt;36\u00b0C) is a common complication of anesthesia increasing the risk for maternal cardiovascular events and coagulative disorders, and can also influence neonatal health. The aim of our work was to evaluate the impact of combined warming strategies on maternal core temperature, measured with the SpotOn. We hypothesized that combined modalities of active warming prevent hypothermia in pregnant women undergoing cesarean delivery with spinal anesthesia.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Seventy-eight pregnant women were randomly allocated into three study groups receiving warmed IV fluids and forced-air warming (AW), warmed IV fluids (WF), or no warming (NW). Noninvasive core temperature device (SpotOn) measured maternal core temperature intraoperatively and for 30 min after surgery. Maternal mean arterial pressure, incidence of shivering, thermal comfort and newborn's APGAR, axillary temperature, weight, and blood gas analysis were also recorded.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Incidence of hypothermia was of 0% in AW, 4% in WF, and 47% in NW. Core temperature in AW was constantly higher than WF and NW groups. Incidence of shivering in perioperative time was significantly lower in AW and WF groups compared with the NW group (\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt; 0.04). Thermal comfort was higher in both AW and WF groups compared with NW group (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.02 and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.008, respectively). There were no significant differences among groups for the other evaluated parameters.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Combined modalities of active warming are effective in preventing perioperative hypothermia. The routine uses of combined AW are suggested in the setting of cesarean delivery.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2021.734768","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:32:23Z","timestamp":1640219543000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Effectiveness of Combined Strategies for the Prevention of Hypothermia Measured by Noninvasive Zero-Heat Flux Thermometer During Cesarean Section"],"prefix":"10.3389","volume":"8","author":[{"given":"Antonella","family":"Cotoia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Sara","family":"Mariotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Ferialdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Del Vecchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Zaami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Cinnella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1213\/ANE.0000000000002604","article-title":"Inadvertent perioperative hypothermia induced by spinal anesthesia for cesarean delivery might be more significant than we think: are we doing enough to warm our parturients?","volume":"126","author":"Allen","year":"2018","journal-title":"Anesth Analg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1213\/ANE.0000000000001181","article-title":"Active warming utilizing combined IV fluid and forced-air warming decreases hypothermia and improves maternal comfort during cesarean delivery: a randomized control trial","volume":"122","author":"Cobb","year":"2016","journal-title":"Anesth Analg."},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1093\/bja\/aev325","article-title":"The Effect of patient warming during Caesarean delivery on maternal and neonatal outcomes: A meta-analysis","volume-title":"Br J Anaesth.","author":"Sultan","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1213\/01.ane.0000286167.96410.27","article-title":"Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does not prevent maternal hypothermia","volume":"105","author":"Butwick","year":"2007","journal-title":"Anesth Analg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1097\/00000542-199503000-00008","article-title":"Heat flow and distribution during induction of general anesthesia","volume":"82","author":"Matsukawa","year":"1995","journal-title":"Anesthesiology."},{"key":"B6","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1097\/00000542-199804000-00002","article-title":"Epidural anesthesia reduces the gain and maximum intensity of shivering","volume":"88","author":"Kim","year":"1998","journal-title":"Anesthesiology."},{"key":"B7","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1097\/00000542-200002000-00042","article-title":"Perioperative heat balance","volume":"92","author":"Sessler","year":"2000","journal-title":"Anesthesiology."},{"key":"B8","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1097\/00000542-200108000-00040","article-title":"Complications and treatment of mild hypothermia","volume":"95","author":"Sessler","year":"2001","journal-title":"Anesthesiology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1056\/NEJM199605093341901","article-title":"Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. 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