Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic sear...Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.展开更多
文摘Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.
