The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis
Background/Objectives: Hypothermia can affect multiple organ systems and reduce patient comfort and is an independent predictor of mortality in trauma patients. Early prevention and management prehospitally is critical and can be approached by “warming” patients using active and/or passive measures....
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MDPI AG
2024-11-01
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| Series: | Trauma Care |
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| Online Access: | https://www.mdpi.com/2673-866X/4/4/26 |
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| author | Lauren Johnstone Zubair Ahmed |
| author_facet | Lauren Johnstone Zubair Ahmed |
| author_sort | Lauren Johnstone |
| collection | DOAJ |
| description | Background/Objectives: Hypothermia can affect multiple organ systems and reduce patient comfort and is an independent predictor of mortality in trauma patients. Early prevention and management prehospitally is critical and can be approached by “warming” patients using active and/or passive measures. Therefore, this systematic review aimed to determine the efficacy of prehospital active warming (AW) in trauma patients. Methods: MEDLINE, Embase, Web of Science and CENTRAL were searched up to June 2024 for studies meeting our inclusion and exclusion criteria. Six studies were identified: four randomised controlled trials (RCTs), a non-randomised trial and an observational study. A risk-of-bias assessment was conducted using either the Cochrane Risk of Bias 2 tool or the ROBINS-I tool. Results: For the primary outcome of end core body temperature (CBT), our meta-analysis calculated a statistically significant mean difference of 0.62 °C ([95%CI: 0.17, 1.07], <i>p</i> = 0.007), favouring AW. For the secondary outcomes of end heart rate and end systolic blood pressure, the mean differences favoured the AW and control groups, respectively, but were not statistically significant (<i>p</i> = 0.45 and <i>p</i> = 0.64). Two of the four RCTs had an overall moderate to high risk of bias, whilst the two observational studies had a high risk of bias. Conclusions: Overall, our results suggest that AW may be effective at managing CBT, but our results are limited by a small sample size, a serious/high overall risk of bias and variable study characteristics. Larger, high-quality studies are needed to inform clinical practice and guidelines. |
| format | Article |
| id | doaj-art-a7f753588713498eba2a0b06f3512e50 |
| institution | Kabale University |
| issn | 2673-866X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Trauma Care |
| spelling | doaj-art-a7f753588713498eba2a0b06f3512e502024-12-27T14:57:05ZengMDPI AGTrauma Care2673-866X2024-11-014431232810.3390/traumacare4040026The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-AnalysisLauren Johnstone0Zubair Ahmed1Department of Inflammation and Ageing, School of Infection, Inflammation & Immunology, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKDepartment of Inflammation and Ageing, School of Infection, Inflammation & Immunology, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UKBackground/Objectives: Hypothermia can affect multiple organ systems and reduce patient comfort and is an independent predictor of mortality in trauma patients. Early prevention and management prehospitally is critical and can be approached by “warming” patients using active and/or passive measures. Therefore, this systematic review aimed to determine the efficacy of prehospital active warming (AW) in trauma patients. Methods: MEDLINE, Embase, Web of Science and CENTRAL were searched up to June 2024 for studies meeting our inclusion and exclusion criteria. Six studies were identified: four randomised controlled trials (RCTs), a non-randomised trial and an observational study. A risk-of-bias assessment was conducted using either the Cochrane Risk of Bias 2 tool or the ROBINS-I tool. Results: For the primary outcome of end core body temperature (CBT), our meta-analysis calculated a statistically significant mean difference of 0.62 °C ([95%CI: 0.17, 1.07], <i>p</i> = 0.007), favouring AW. For the secondary outcomes of end heart rate and end systolic blood pressure, the mean differences favoured the AW and control groups, respectively, but were not statistically significant (<i>p</i> = 0.45 and <i>p</i> = 0.64). Two of the four RCTs had an overall moderate to high risk of bias, whilst the two observational studies had a high risk of bias. Conclusions: Overall, our results suggest that AW may be effective at managing CBT, but our results are limited by a small sample size, a serious/high overall risk of bias and variable study characteristics. Larger, high-quality studies are needed to inform clinical practice and guidelines.https://www.mdpi.com/2673-866X/4/4/26active warminghypothermiacore body temperatureprehospital |
| spellingShingle | Lauren Johnstone Zubair Ahmed The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis Trauma Care active warming hypothermia core body temperature prehospital |
| title | The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis |
| title_full | The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis |
| title_fullStr | The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis |
| title_short | The Efficacy of Active Warming in Prehospital Trauma Care: A Systematic Review and Meta-Analysis |
| title_sort | efficacy of active warming in prehospital trauma care a systematic review and meta analysis |
| topic | active warming hypothermia core body temperature prehospital |
| url | https://www.mdpi.com/2673-866X/4/4/26 |
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