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The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis
BACKGROUND: Perioperative cardiovascular events are a common contributor to perioperative morbidity and mortality. Patient warming affects the cardiovascular system in various ways and may protect against cardiovascular events. We aimed to estimate the effect of active patient warming on perioperati...
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| Format: | Thesis |
| Language: | English Eng |
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Department of Anaesthesia and Perioperative Medicine
2024
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| _version_ | 1867613140494057472 |
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| access_status_str | Open Access |
| author | Mkhize, Sisalindele |
| author2 | Du Toit, Leon |
| author_browse | Du Toit, Leon Mkhize, Sisalindele |
| author_facet | Du Toit, Leon Mkhize, Sisalindele |
| author_sort | Mkhize, Sisalindele |
| collection | Thesis |
| description | BACKGROUND: Perioperative cardiovascular events are a common contributor to perioperative morbidity and mortality. Patient warming affects the cardiovascular system in various ways and may protect against cardiovascular events. We aimed to estimate the effect of active patient warming on perioperative cardiovascular outcomes in clinical trials. METHODS: A systematic review with meta-analyses was conducted. Six data bases were searched from inception until 5th July 2021 for studies that prospectively assigned participants to any physical warming strategy and reported on cardiovascular outcomes. Screening, data extraction and risk of bias assessment were conducted in duplicate. 8782 records were identified. After removing duplicates and screening titles and abstracts, fifty-two full-text articles were assessed for eligibility, fourteen studies with 1711 participants were included in the systematic review and meta-analyses. RESULTS: The effect of physical warming was – risk ratio (95% confidence interval from random effects model) - 0.74 (0.11; 4.73) for major adverse cardiovascular events, 1.07 (0.09; 13.03) for myocardial infarction, 0.56 (0.17; 1.85) for myocardial ischaemia, 0.48 (0.19; 1.20) for arrhythmias and 0.77 (0.25; 2.37) for all-cause mortality. Statistical heterogeneity was not concerning in any of the meta-analyses. All of the meta-analyses carried serious risk of bias and represent low quality evidence. CONCLUSION: We found little information on the treatment effect of active patient warming on cardiovascular outcomes. Inconsistent definitions and reporting of cardiovascular events in patient warming trials confound synthesis of the data. We recommend that prospective studies of patient warming routinely report on cardiovascular outcomes. The effect of active patient warming on perioperative cardiovascular outcomes remains an important unanswered question in perioperative medicine. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39306 |
| institution | University of Cape Town (South Africa) |
| language | English Eng |
| last_indexed | 2026-06-10T12:31:24.573Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Department of Anaesthesia and Perioperative Medicine |
| publisherStr | Department of Anaesthesia and Perioperative Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39306 The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis Mkhize, Sisalindele Du Toit, Leon Biccard , Bruce Anaesthesiology and perioperative medicine BACKGROUND: Perioperative cardiovascular events are a common contributor to perioperative morbidity and mortality. Patient warming affects the cardiovascular system in various ways and may protect against cardiovascular events. We aimed to estimate the effect of active patient warming on perioperative cardiovascular outcomes in clinical trials. METHODS: A systematic review with meta-analyses was conducted. Six data bases were searched from inception until 5th July 2021 for studies that prospectively assigned participants to any physical warming strategy and reported on cardiovascular outcomes. Screening, data extraction and risk of bias assessment were conducted in duplicate. 8782 records were identified. After removing duplicates and screening titles and abstracts, fifty-two full-text articles were assessed for eligibility, fourteen studies with 1711 participants were included in the systematic review and meta-analyses. RESULTS: The effect of physical warming was – risk ratio (95% confidence interval from random effects model) - 0.74 (0.11; 4.73) for major adverse cardiovascular events, 1.07 (0.09; 13.03) for myocardial infarction, 0.56 (0.17; 1.85) for myocardial ischaemia, 0.48 (0.19; 1.20) for arrhythmias and 0.77 (0.25; 2.37) for all-cause mortality. Statistical heterogeneity was not concerning in any of the meta-analyses. All of the meta-analyses carried serious risk of bias and represent low quality evidence. CONCLUSION: We found little information on the treatment effect of active patient warming on cardiovascular outcomes. Inconsistent definitions and reporting of cardiovascular events in patient warming trials confound synthesis of the data. We recommend that prospective studies of patient warming routinely report on cardiovascular outcomes. The effect of active patient warming on perioperative cardiovascular outcomes remains an important unanswered question in perioperative medicine. 2024-04-04T08:37:48Z 2024-04-04T08:37:48Z 2023 2024-04-04T08:32:27Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39306 en Eng application/pdf Department of Anaesthesia and Perioperative Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Anaesthesiology and perioperative medicine Mkhize, Sisalindele The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| thesis_degree_str | Master's |
| title | The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| title_full | The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| title_fullStr | The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| title_full_unstemmed | The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| title_short | The effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials: A systematic review and meta-analysis |
| title_sort | effect of patient warming on perioperative cardiovascular outcomes in interventional clinical trials a systematic review and meta analysis |
| topic | Anaesthesiology and perioperative medicine |
| url | http://hdl.handle.net/11427/39306 |
| work_keys_str_mv | AT mkhizesisalindele theeffectofpatientwarmingonperioperativecardiovascularoutcomesininterventionalclinicaltrialsasystematicreviewandmetaanalysis AT mkhizesisalindele effectofpatientwarmingonperioperativecardiovascularoutcomesininterventionalclinicaltrialsasystematicreviewandmetaanalysis |