- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02201095
Active Warming During Elective Caesearean Section
Active Warming for Elective Caesarean Section - a RCT
During anaesthesia for caesarean section it is common to lose heat and become hypothermic, (<36 degrees C). In order to try and avoid this all women are given warmed intravenous fluid and insulated from cold surfaces. There are also 2 types of machine available to actively warm women;
- Forced Air Warming - that uses a disposable sheet the woman lies upon with lots of air pockets that have warm air blown into them continuously by a fan.
- Conduction Warming Mattress - a thin mattress which covers the operating table and the woman lies on top. The padded mattress has strips of material that heat up when electricity passes through it, similar to a normal electric blanket.
We plan to carry out a randomised controlled trial to compare these 2 methods with the current practice of no active warming.
The hypothesis for this study is that active warming women during elective caesarean section prevents women's temperature from dropping and keeps them more comfortable than if active warming were not used.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
When a baby is delivered by a surgical procedure (a caesarean section) the woman will usually have a "spinal" anaesthetic. With a "spinal", local anaesthetic is injected into the spinal fluid to make the woman numb from her chest to her feet, allowing her to be comfortable but awake during the birth. During this type of anaesthetic it is common to lose heat and become cold or "hypothermic" measured as less than 36 degrees Celsius. Becoming this cold can be uncomfortable for the woman but also causes other problems. It can make blood clotting less effective, alter the way wounds heal afterwards and make the woman more likely to develop infections or problems related to her heart and lungs.
To help keep their temperature stable, the investigators give all women fluid into the veins that is already warm and ensure that they are well insulated from any cold surfaces. There are two machines that the investigators can also use to actively warm patients but these are not yet used in every case. The first method is called "Forced Air Warming" and uses a special disposable sheet the woman lies upon with lots of air pockets that have warm air blown into them continuously by a fan. The woman is surrounded by these pockets of warm air, which help to warm her and also insulate against heat loss. The second method is called a "Conduction Warming Mattress" and uses a thin mattress which covers the operating table and the woman lies on top. The padded mattress has strips of material that heat up when electricity passes through it, similar to a normal electric blanket.
The investigators have already looked at the records of some women having caesarean sections in our hospital and found that both forced air warming and conduction mattress warming seem to help them stay warm. However, the investigators would like to study this in more detail and prove scientifically whether these methods are effective. Our aim in this study is to see if warming machines can help prevent women getting too cold, and prove scientifically whether one is more effective.
The hypothesis for this study is that active warming women during elective caesarean section prevents women's temperature from dropping and keeps them more comfortable than if active warming were not used.
The women will have exactly the same anaesthetic as they would have had if they were not in the study. If a woman agrees to be in the study she will be chosen randomly to receive either, normal care (including warmed fluids but no warming machines), additional warming with forced air or additional warming by conduction mattress. Her temperature will be measured at regular intervals before, during and after the caesarean section, at the same time she will be asked to score herself on a thermal comfort scale. The results will be analysed to compare the temperature changes in each group.
The investigators hope that the active warming machines will keep body temperature stable and prevent hypothermia. If the investigators find out that these machines prevent women getting cold, they can ensure that the most effective methods of warming during caesarean section operations are used and minimise problems due to becoming cold.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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South Yorkshire
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Sheffield, South Yorkshire, United Kingdom, S10 2JF
- Sheffield teaching Hospitals NHS Trust
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a singleton, uncomplicated pregnancy, presenting for elective caesarean section under spinal anaesthesia, where surgery and anaesthesia are expected to be uncomplicated. Patients scheduled for tubal ligation surgery (sterilisation) as part of the caesarean section may also be included.
Exclusion Criteria:
- Age under 18
- BMI <19 or >30
- Diseases of pregnancy: e.g. pregnancy induced hypertension
- Grand Multiparity - ie parity of 5 or greater
- Pre-operative pyrexia (temperature of 37.5 degrees C or greater)
- Pre-operative hypothermia (temperature 36.0 degrees or cooler)
- Significant co-existing maternal disease - e.g. congenital heart disease
- Co-existing maternal disease that could impact on temperature- e.g. hypo/hyperthyroid
- Coagulation abnormalities or anticipated excessive blood loss including any form of abnormal placentation
- Surgical procedure expected not to be routine/deviation from normal practice
- Condition preventing full, informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Normal care
Normal care - no active warming
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Active Comparator: Forced air warming
Underbody forced air warming blanket
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Other Names:
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Active Comparator: Conduction warming mattress
Underbody conduction warming mattress
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Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean temperature on arrival in recovery
Time Frame: Temperature will be measured on arrival in recovery.
|
The primary outcome of the study is to find whether there is a clinically significant statistical difference between the mean temperatures on arrival in recovery of the control and conduction mattress groups; the control and forced air warming groups; and the conduction mattress and forced air warming groups.
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Temperature will be measured on arrival in recovery.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Peri-operative hypothermia
Time Frame: Temperature will be measured evry 15 minutes throughout the duration of the procedure and in recovery room. The investigators anticipate that this will be over approximately a 2 hour period.
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To find whether these active warming devices significantly reduce the incidence of peri-operative hypothermia during spinal anaesthesia for caesarean section
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Temperature will be measured evry 15 minutes throughout the duration of the procedure and in recovery room. The investigators anticipate that this will be over approximately a 2 hour period.
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Thermal comfort scores
Time Frame: Thermal comfort will be assessed and scored at 15 minute intervals during surgery and in recovery. We anticipate that this will occur over approximately 2 hours.
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To assess whether active warming makes patients too hot and assess maternal thermal comfort and satisfaction during active warming.
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Thermal comfort will be assessed and scored at 15 minute intervals during surgery and in recovery. We anticipate that this will occur over approximately 2 hours.
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Collaborators and Investigators
Investigators
- Principal Investigator: Melanie J Woolnough, Mb ChB, Sheffield Teaching Hospitals NHS Foundation Trust
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STH18196
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Preoperative Hypothermia
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University Hospital Schleswig-HolsteinCompletedGeneral Anaesthesia | Perioperative Hypothermia | Preoperative Warming | Prewarming | Epidural Anaesthesia | Temperature MonitoringGermany
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Molnlycke Health Care ABCompletedInadvertent Perioperative Hypothermia | Preoperative Anxiety Experienced by the PatientGermany, United Kingdom, Norway
-
Boston Intelligent Medical Research Center, Shenzhen...Tsinghua UniversityNot yet recruitingPreoperative Care
-
Cairo UniversityCompletedPreoperative SedationEgypt
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Jiangsu HengRui Medicine Co., Ltd.Active, not recruitingPreoperative SedationChina
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Jiangsu HengRui Medicine Co., Ltd.CompletedPreoperative SedationChina
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SMG-SNU Boramae Medical CenterUnknownPreoperative Fasting
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University Children's Hospital, ZurichCompleted
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KU LeuvenRecruitingPreoperative Anxiety | Preoperative CareBelgium
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Northumbria UniversitySheffield Teaching Hospitals NHS Foundation Trust; Aalborg University; South... and other collaboratorsRecruitingPreoperative Care | ValidityUnited Kingdom
Clinical Trials on Forced air warming
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Medical University of ViennaSuspendedHypothermia | PolytraumaAustria
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Hacettepe UniversityCigdem Yucel; Ozgur OzyuncuActive, not recruitingCesarean Section Complications | HypothermiaTurkey
-
Indus Hospital and Health NetworkUnknownForced Air Warming Effect on HypothermiaPakistan
-
Dokuz Eylul UniversityCompletedSurgical Site Infection
-
Medical University of ViennaCompleted
-
Virginia Commonwealth UniversityRecruitingCesarean SectionUnited States
-
The University of Texas Health Science Center,...RecruitingHypothermia; Anesthesia | Hypothermia, Newborn | Hypothermia, SequelaUnited States
-
Vanderbilt UniversityWithdrawnCesarean SectionUnited States
-
Hacettepe UniversityCompletedTemperature Change, BodyTurkey
-
Mahidol UniversityCompletedHypothermia | Vascular Surgery | Forced-air Warming Mattress | Circulating-water MattressThailand