title: The effects of a resistive warming mattress during caesarean section: a randomised, controlled trial.
abstract: BACKGROUND
  The adverse effects of inadvertent perioperative hypothermia in the surgical population are well established. The aim of this study was to investigate whether a resistive warming mattress would reduce the incidence of inadvertent perioperative hypothermia in patients undergoing elective caesarean section.
  
  
  METHODS
  A total of 116 pregnant women booked for elective caesarean section were randomised to either intraoperative warming with a mattress or control. The primary outcome was the incidence of inadvertent perioperative hypothermia, defined as a temperature <36.0 °C on admission to the recovery room. Shivering in the perioperative period, severity of shivering and the need for treatment, total blood loss, fall in haemoglobin, incidence of blood transfusion, immediate health of baby, and length of hospital stay were also recorded.
  
  
  RESULTS
  The incidence of inadvertent perioperative hypothermia in the mattress-warmed group was significantly lower than in the control group (5.2% vs. 19.0%, P=0.043); mean temperatures differed between the two groups, 36.5 °C and 36.3 °C, respectively (P=0.046). There was also a significantly lower mean (± SD) haemoglobin change in the mattress-warmed group at -1.1±0.9 g/dL versus -1.6±0.9 g/dL in the control group (P=0.007). There was no difference in shivering (P=0.798).
  
  
  CONCLUSIONS
  A resistive warming mattress reduced the incidence of inadvertent perioperative hypothermia and attenuated the fall in haemoglobin. The use of resistive mattress warming should be considered during caesarean section.
authors.affiliation: Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, UK. Electronic address: a.chakladar@nhs.net.
authors.forename: A
authors.initials: A
authors.lastname: Chakladar
authors.affiliation: Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Dixon
authors.affiliation: Clinical Investigation and Research Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, UK.
authors.forename: D
authors.initials: D
authors.lastname: Crook
authors.affiliation: Department of Anaesthesia, Brighton and Sussex University Hospitals NHS Trust, Brighton, East Sussex, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: Harper
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000503:physiopathology; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D012768:Shivering
chemical_list: D006454:Hemoglobins
keywords: Anaesthesia, obstetric; Caesarean section; Complications, anaemia; Complications, hypothermia; Equipment, warming devices; Temperature, monitoring