2. Materials and Methods
hypothermia, fever, cognitive impairment, infections, anemia, burns, skin alterations, blood transfusions, shivering, diabetes
INFECTIONS, ANEMIA, PRESSURE ULCERS, PERIPHERAL NEUROPATHY, CHRONIC ANEMIA, DIABETES
We performed a single-center, pragmatic randomized clinical trial (RCT) with adults planned for elective non-cardiac surgery. The study was approved by the Getafe University Hospital Ethics Committee and by the Torrejón University Hospital research committee (30 November 2018, A10/18, President of Hospital Ethics Committee: Ricardo Sanz Fernandez), and written informed consent was obtained from all subjects participating in the trial. The RCT was registered prior to patient enrollment at We included adults (>18 years old) classified as American Society of Anesthesiologists (ASA) physical status I, II or III, scheduled for elective non-cardiac surgery performed under general and/or neuraxial anesthesia with a minimum expected duration of anesthesia of 60 min in the Torrejón University Hospital, Madrid, Spain.Exclusion criteria were cognitive impairment or any kind of lack of collaboration, pregnancy, diabetes with established peripheral neuropathy, pre-surgical treatment with drugs interfering with thermoregulation (i.e., ketamine, thyroxine), burns, pressure ulcers and other skin alterations that may worsen under application of heating devices, initial patient temperature < 35.5 °C or >37.5 °C, fever or active infections, chronic anemia requiring periodic transfusions.The primary objective was to evaluate the effect of a prewarming period lasting at least 10 min and performed with a forced air system on perioperative hypothermia. In terms of temporal window for the evaluation of perioperative hypothermia, we considered the period occurring from the induction of anesthesia to the arrival in the recovery room (or in the ICU). Perioperative hypothermia was evaluated in terms of incidence (defined as a temperature < 36 °C), magnitude (expressed in °C · hSecondary outcomes were (1) the core temperature at operating room arrival, (2) the occurrence of side effects defined as thermal discomfort (presence of shivering or sweating, which were directly objectified, or discomfort reported directly by the patient); and (3) the incidence of SSI, amount of blood losses and number of blood transfusions, occurrence of anemia (defined as episodes of hemoglobin levels below 7 mg/dl) and the duration of hospital stay (confirmed by electronic medical records). 