***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters . We aim ed to evaluate the efficacy of low-cost , low-power warming methods for maintaining normothermia in abdominal surgery patients . Methods Patients ( n = 160 ) scheduled for elective abdominal surgery were included in this prospect i ve clinical study . Five warming methods were applied : heated blood transfusion/fluid infusion vs. unheated ; wrapping patients vs. not wrapping ; applying moist dressings , heated or not ; surgical field rinse heated or not ; and applying heating blankets or not . Patients ’ nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy . Significant differences were found in mean temperatures of warmed patients compared to those not warmed . Results When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods , significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls . Discussion The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted . Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket ; combined body wrapping , heated moist dressings , and heating blanket ; combined body wrapping , heated moist dressings , and warmed surgical rinse fluid , with or without heating blanket . These methods are practically applicable when low-cost method is indeed needed BACKGROUND Mild perioperative hypothermia , which is common during major surgery , may promote surgical-wound infection by triggering thermoregulatory vasoconstriction , which decreases subcutaneous oxygen tension . Reduced levels of oxygen in tissue impair oxidative killing by neutrophils and decrease the strength of the healing wound by reducing the deposition of collagen . Hypothermia also directly impairs immune function . We tested the hypothesis that hypothermia both increases susceptibility to surgical-wound infection and lengthens hospitalization . METHODS Two hundred patients undergoing colorectal surgery were r and omly assigned to routine intraoperative thermal care ( the hypothermia group ) or additional warming ( the normothermia group ) . The patient 's anesthetic care was st and ardized , and they were all given cefam and ole and metronidazole . In a double-blind protocol , their wounds were evaluated daily until discharge from the hospital and in the clinic after two weeks ; wounds containing culture-positive pus were considered infected . The patients ' surgeons remained unaware of the patients ' group assignments . RESULTS The mean ( + /- SD ) final intraoperative core temperature was 34.7 + /- 0.6 degrees C in the hypothermia group and 36.6 + /- 0.5 degrees C in the normothermia group ( P < 0.001 ) Surgical-wound infections were found in 18 of 96 patients assigned to hypothermia ( 19 percent ) but in only 6 of 104 patients assigned to normothermia ( 6 percent , P = 0.009 ) . The sutures were removed one day later in the patients assigned to hypothermia than in those assigned to normothermia ( P = 0.002 ) , and the duration of hospitalization was prolonged by 2.6 days ( approximately 20 percent ) in hypothermia group ( P = 0.01 ) . CONCLUSIONS Hypothermia itself may delay healing and predispose patients to wound infections . Maintaining normothermia intraoperatively is likely to decrease the incidence of infectious complications in patients undergoing colorectal resection and to shorten their hospitalizations In this prospect i ve trial a study was made of the effect of warm irrigation on blood loss during  transurethral prostatectomy ( TURP ) . A control group of 21 patients in whom irrigating fluid at operating room temperature ( mean 21.5 degrees C ) had been used was compared with a statistically comparable group of 19 patients in whom warm irrigating fluid ( mean 33.1 degrees C ) had been used .  Blood loss in ml , in ml/g of tissue resected and in ml/min of resection time was not increased by the use of warm rather than room temperature irrigation . It was found that warm irrigation decreased heat loss and shivering in the patient during TURP and led to improved comfort both for patient and operator . The method of heating the irrigation bags was safe and economical Changes in mean body temperature and muscle protein metabolism were studied in elderly patients undergoing large bowel surgery .  Two groups were studied : in one , efforts were made to maintain the patients normothermic during and after surgery by warming the fresh gases , the i.v . fluids , by placing warmed cotton padding around the exposed parts of the body and by covering the patients with a metallized plastic sheet in the recovery period . The other group received routine management . Otherwise the anaesthetic technique was comparable . The excretion of the amino acid 3-methylhistidine ( 3-MeH ) , an indicator of muscle protein breakdown , and urea nitrogen loss were measured in the urine collected the day before , and on the 2nd and 4th postoperative days . Prevention of heat loss during and after surgery caused a significant decrease in muscle protein degradation and nitrogen loss OBJECTIVE to verify the effectiveness of warmed intravenous infusion for hypothermia prevention in patients during the intraoperative period . METHOD experimental , comparative , field , prospect i ve and quantitative study undertaken at a federal public hospital . The sample was composed of 60 adults , included based on the criteria of axillary temperature between 36ºC and 37.1ºC and surgical abdominal access , divided into control and experimental groups , using the systematic probability sampling technique . RESULTS 22 patients ( 73.4 % ) from both groups left the operating room with hypothermia , that is , with temperatures below 36ºC ( p=1.0000 ) . The operating room temperature when patients arrived and patients ' temperature when they arrived at the operating room were statistically significant to affect the occurrence of hypothermia . CONCLUSION the planning and implementation of nursing interventions carried out by baccalaureate nurses are essential for preventing hypothermia and maintaining perioperative normothermia Mild intraoperative hypothermia is common . We therefore studied the effects of mild hypothermia on  propofol pharmacokinetics , hepatic blood flow , and atracurium duration of action in healthy volunteers . Six young volunteers were studied on two r and omly assigned days , at either 34 degrees C or 37 degrees C. Anesthesia was induced with thiopental , 3 mg/kg , and maintained with 70 % N2 O and 0.6 % isoflurane . Core hypothermia was induced by conductive and convective cooling . On the other study day , normothermia was maintained by a Bair Hugger Registered Trademark ( Augustine Medical , Inc. , Eden Prairie , MN ) forced-air warmer . Propofol , 1 mg/kg lean body mass ( LBM ) , then was given , followed by a 4-h infusion at 5 mg centered dot kg-1 centered dot h-1 . After 2 h , atracurium 0.5 mg/kg was administered as an intravenous bolus . Indocyanine green was administered for estimation of hepatic blood flow . Arterial blood was assayed for propofol and indocyanine green concentration . Pharmacokinetic analysis was performed using NONMEM . Results are reported as means + /- SEM .  Propofol blood concentrations averaged approximate equals 28 % more at 34 degrees C than at 37 degrees C ( P < 0.05 ) . Hepatic blood flow decreased 23 % + /- 11 % in normothermic volunteers during the propofol infusion , and 33 % + /- 11 % in hypothermic volunteers ( P = not significant ) . A three-compartment mamillary model fitted the data best . Inclusion of hepatic blood flow change from the prepropofol baseline as a covariate for total body clearance significantly improved the fit . The intercompartmental clearances were decreased in the presence of hypothermia . Core hypothermia prolonged the time to recovery of the first twitch in the train-of-four to 10 % of its control value ( T1 = 10 % ) after atracurium administration by approximate equals 60 % ( P < 0.05 ) , from 44 + /- 4 min to 68 + /- 7 min . In contrast , T1 = 25%-75 % remained unchanged . We conclude that 3 degrees C of core hypothermia increased propofol blood concentrations and prolonged atracurium duration of action . Hepatic blood flow was decreased during propofol administration , and this change was a significant predictor of propofol clearance , indicating that the effect of propofol on hepatic blood flow impairs the clearance of propofol itself . ( Anesth Analg 1995;80:1007 - 14 Twenty-four unpremedicated patients of ASA class II or III undergoing TURP were given esia with 10 mg of tetracaine at level L3 - 4 or L4 - 5 . These patients were r and omly given " warm " or " ambient temperature " irrigating fluids . Those with irrigating fluids of temperature between 25.5 degrees C and 33 degrees C were arranged as Group 1 and those of temperature between 21.5 and 23 degrees C as Group 2 . The results failed to show that the incidence of shivering could be decreased by the use of warm irrigating fluids Background Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia . We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering . Methods Forty five patients undergoing elective cesarean section were r and omly assigned to three groups . Group F received warmed intravenous fluid ( 40 ℃ ) . Group A patients were actively warmed by forced air-warming . Group C was the control group . Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia  . Core temperature ( tympanic membrane ) and the skin temperature of arm and thigh were measured and shivering was grade d simultaneously . Results The core temperature at 45 min decreased less in Groups F and A than Group C ( -0.5 ℃ ± 0.3 ℃ vs -0.6 ℃ ± 0.4 ℃ vs -0.9 ℃ ± 0.4 ℃ , respectively ; P = 0.004 ) . The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C ( P = 0.001 and P = 0.012 , respectively ) . Leg temperature increased similarly among the three groups . The incidence of shivering was significantly less in Group A and Group F than Group C ( 20 % , 13.3 % , and 53.3 % , respectively ; P = 0.035 ) . Conclusions Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia OBJECTIVES To investigate the effect using irrigation fluid at body temperature ( isothermic ) on patients ' ( core ) temperature during a  transurethral resection of the prostate ( TURP )  and on the amount of peri-operative blood loss , the resection time and the subjective assessment of comfort by the patients . PATIENT AND METHODS In a r and omized study , patients undergoing TURP under spinal anaesthesia  were divided into those receiving either isothermic irrigation fluid  ( Group 1.28 patients ) or fluid at room temperature  ( Group 2.31 patients ) . In Group 1 , a fluid heater maintained the irrigation fluid at body temperature until it reached the bladder . The body temperature of the patients was recorded rectally and orally during and after TURP and the peri-operative blood loss was also measured . The patients were interviewed on the first day after TURP to determine their assessment of comfort during the procedure . RESULTS The decrease in body temperature was 0.74 degree C in Group 1 and 1.71 degrees C in Group 2 , which was significantly different ( P < 0.001 ) . There was no significant difference in blood loss or resection-time . In Group 1 , only four ( 14 % ) of the patients were aware that their body was cooler , compared to 15 ( 50 % ) in Group 2 ( P = 0.038 ) . CONCLUSION Isothermic irrigation during TURP prevents excessive cooling and reduces the level of hypothermia . The reported increased mortality after TURP is probably related to peri-operative cardiac stress , an important factor which could be caused by the rapid decrease in body temperature which accompanies normal irrigation . Because the heating equipment presently available does not interfere with TURP , there are strong arguments for performing every TURP with irrigation fluid at body temperature Purpose To determine the relative efficacy of heat conservation and convective warming in maintaining penoperative normothermia . ( central temperature ≥36 ° C ) . Methods Thirty-seven patients undergoing elective gynaecological , orthopaedic , or general surgery scheduled to last two hours were prospect jvely studied . Patients were r and omized to one of two groups . Group I patients received heat conservation with reflective blankets ( Thermadrape ™ , Vital Signs , Inc. , Totowa , NJ ) applied preoperatively and warmed iv fluids ( Hotline ™ SIMS Level I Technologies , Inc , Rockl and , MA ) . Group 2 patients received convective warming ( BairHugger , Augustine Medical , Inc. , Eden Prairie , MN ) after induction of anaesthesia and iv flu 
    Output:
    
Evidence was unclear regarding the effects of fluid warming on bleeding .
Warmed intravenous fluids also further reduced the risk of shivering compared with room temperature intravenous fluidsInvestigators reported no statistically significant differences in core body temperature or shivering between individuals given warmed and room temperature irrigation fluids .
AUTHORS ' CONCLUSIONS Warm intravenous fluids appear to keep patients warmer during surgery than room temperature fluids .
It is unclear whether the actual differences in temperature are clinical ly meaningful , or if other benefits or harms are associated with the use of warmed fluids .
It is also unclear if using fluid warming in addition to other warming methods confers any benefit , as a ceiling effect is likely when multiple methods of warming are used