Combining infusion warmer and automatic infusion pressure bag to stabilize blood pressure and body temperature in caesarean section
DOI: https://doi.org/10.33024/minh.v8i10.1464
Automatic Infusion Pressure Bag Blood Pressure Body Temperature Caesarean Section Fluid Warmer
Abstract
Background: Patients undergoing caesarean section (CS) with spinal anaesthesia are at risk of hypotension and hypothermia due to peripheral vasodilation and decreased venous return. These conditions may be exacerbated by the administration of room-temperature intravenous fluids (21–23°C) and manual pressure infusion. Using a fluid warmer can help prevent hypothermia, while an automatic infusion pressure bag can accelerate fluid delivery, potentially maintaining blood pressure and body temperature stability. However, these interventions have not yet been studied as a combined approach.
Purpose: To evaluate the effect of using a fluid warmer in combination with an automatic infusion pressure bag on blood pressure and body temperature in patients undergoing caesarean section.
Method: This quasi-experimental study used a pre-test and post-test with control group design and included 64 patients undergoing CS, divided into intervention and control groups. The intervention group received warmed fluids (37–39°C) administered through an automatic infusion pressure bag from the sign-in phase until discharge from the recovery room. Measurements were taken at four time points: preoperatively during sign-in, intraoperatively at 15 and 30 minutes after anaesthesia induction, and postoperatively 15 minutes in the recovery room.
Results: There was no statistically significant difference in blood pressure between groups (p > 0.05), although a small clinical effect was observed (ηp² = 0.01–0.06). Body temperature showed statistically and clinically significant differences at all measurement points (p < 0.05, ηp² > 0.14), indicating a strong effect of the intervention.
Conclusion: The use of a fluid warmer combined with an automatic infusion pressure bag is clinically effective in maintaining blood pressure stability and statistically and clinically effective in stabilizing body temperature during caesarean section procedures.
Downloads
References
Afrida, M., Nurwidiyanti, E., & Marfuah, M. (2021). Relationship between Spinal Anesthesia and Hypothermia Incidence among Post Operative Patients in the Operating Recovery Room" JIH" Hospital Yogyakarta. D'Nursing and Health Journal (DNHJ), 2(2), 109-121.
Alemayehu, T. Y., Berhe, Y. W., Getnet, H., & Molallign, M. (2020). Hemodynamic changes after spinal anesthesia in preeclamptic patients undergoing cesarean section at a tertiary referral center in Ethiopia: a prospective cohort study. Patient Safety in Surgery, 14(1), 9.
Algarni, R. A., Albakri, H. Y., Albakri, L. A., Alsharif, R. M., Alrajhi, R. K., Makki, R. M., & Alsharif, R. (2023). Incidence and risk factors of spinal anesthesia-related complications after an elective cesarean section: a retrospective cohort study. Cureus, 15(1).
Alley, T., Taylor, G., Owens, A., Goodin, J. W., Rasnake, N., Daley, B. J., & Clark, C. T. (2020). Whole blood administration: comparison of in vitro platelet function of pressure bag, pressure bag with fluid warming device, and rapid infuser methods. Journal of Trauma Nursing| JTN, 27(6), 351-354.
Alligood, M. R. (2013). Nursing theory: Utilization & application. Elsevier Health Sciences.
American Society of Anesthesiologists. (2020). Statement on ASA Physical Status Classification System. Retrieved from: https://sedatium.com/wp-content/uploads/2021/03/ASA-Physical-Status-Classification-System-Diciembre-2020-American-Society-of-Anesthesiologists.pdf
Bower, J. R., & Kinsella, S. M. (2020). Preventing and treating hypotension during spinal anaesthesia for caesarean section. BJA education, 20(11), 360-361.
Cantürk, M., Cantürk, F. K., Kocaoğlu, N., & Hakki, M. (2019). The effects of crystalloid warming on maternal body temperature and fetal outcomes: a randomized controlled trial. Revista Brasileira de Anestesiologia, 69(1), 13-19.
Chen, Y., Xu, X., Qin, R., Guo, L., & Ni, X. (2023). Comparison of crystalloid and colloid co-load combined with norepinephrine prophylaxis on post-spinal anesthesia hypotension during cesarean delivery: a randomized sequential allocation dose-finding study. Frontiers in Medicine, 10, 1214598.
Cho, S. A., Yoon, S., Lee, S. J., Jee, Y. S., Cho, C. K., & Sung, T. Y. (2022). Clinical efficacy of short-term prewarming in elderly and adult patients: A prospective observational study. International Journal of Medical Sciences, 19(10), 1548.
Delicce, A. V., & Makaryus, A. N. (2017). Physiology, frank starling law.
Ebrie, A. M., Woldeyohanis, M., Abafita, B. J., Ali, S. A., Zemedkun, A., Yimer, Y., & Mohammed, S. (2022). Hemodynamic and analgesic effect of intrathecal fentanyl with bupivacaine in patients undergoing elective cesarean section; a prospective cohort study. Plos one, 17(7), e0268318.
Elgzar, W. T. I., Said, H. I. I., & Ibrahim, H. A. F. (2019). Corrigendum to “Effect of lower leg compression during cesarean section on post-spinal hypotension and neonatal hemodynamic parameters: Nonrandomized controlled clinical trial”[Int J Nurs Sci 6/3 (2019) 252–258]. International Journal of Nursing Sciences, 6(4), 478.
Ferede, Y. A., Aytolign, H. A., & Mersha, A. T. (2021). “The magnitude and associated factors of intraoperative shivering after cesarean section delivery under Spinal anesthesia’’: A cross sectional study. Annals of Medicine and Surgery, 72, 103022.
Ferré, F., Martin, C., Bosch, L., Kurrek, M., Lairez, O., & Minville, V. (2020). Control of spinal anesthesia-induced hypotension in adults. Local and regional anesthesia, 39-46.
Ji, N., Wang, J., Li, X., & Shang, Y. (2024). Strategies for perioperative hypothermia management: advances in warming techniques and clinical implications: a narrative review. BMC surgery, 24(1), 425.
Kim, H., Kim, T. K., Yoo, S., & Kim, J. T. (2021). Influence of flow rate, fluid temperature, and extension line on Hotline and S-line heating capability: an in vitro study. BMC anesthesiology, 21(1), 1.
Lax, M., Mustola, S. T., Repo, K., Järvinen, J., Bayoro, D. K., Cataldo, S. H., & Waldmann, A. D. (2023). Verification of an intravenous fluid warmer: A prospective, two-center observational trial. SAGE Open Medicine, 11, 20503121231182517.
Liu, M., & Qi, L. (2021). The related factors and countermeasures of hypothermia in patients during the anesthesia recovery period. American journal of translational research, 13(4), 3459.
Martin, S. M., Fisher, A. D., Meledeo, M. A., Wampler, D., Nicholson, S. E., Raczek, K., & Schauer, S. G. (2021). More sophisticated than a drink cooler or an old sphygmomanometer but still not adequate for prehospital blood: a market review of commercially available equipment for prehospital blood transport and administration. Transfusion, 61, S286-S293.
Messina, A., La Via, L., Milani, A., Savi, M., Calabrò, L., Sanfilippo, F., & Cecconi, M. (2022). Spinal anesthesia and hypotensive events in hip fracture surgical repair in elderly patients: a meta-analysis. Journal of anesthesia, analgesia and critical care, 2(1), 19.
Ministery of Health of the Republic of Indonesia. (2024). Survei Kesehatan Indonesia Tahun 2023. Jakarta: Kementerian Kesehatan RI.
Mostafa, M. S., Hassan, S. A., & Abdelatef, M. (2023). How to handle hypotension following spinal anesthesia for a cesarean section. Journal of Current Medical Research and Practice, 8(2), 57-61.
Nemeth, M., Miller, C., & Bräuer, A. (2021). Perioperative hypothermia in children. International Journal of Environmental Research and Public Health, 18(14), 7541.
Pan, P., Song, K., Yao, Y., Jiang, T., & Jiang, Q. (2020). The impact of intraoperative hypothermia on blood loss and allogenic blood transfusion in total knee and hip arthroplasty: a retrospective study. BioMed Research International, 2020(1), 1096743.
Patel, S., & Ninave, S. (2024). Postspinal anesthesia hypotension in caesarean delivery: a narrative review. Cureus, 16(4).
Pomalango, Z. B. (2023). Penerapan Teori Keperawatan Comfort Katharine Kolcaba dalam Pemberian Asuhan Keperawatan Perioperatif. Jurnal Anestesi, 1(3), 118-128.
Qi, X., Chen, D., Li, G., Cao, J., Yan, Y., Li, Z., & Li, Y. (2022). Risk factors associated with intraoperative shivering during caesarean section: a prospective nested case-control study. BMC anesthesiology, 22(1), 56.
Ross, P. A., Lerman, J., & Coté, C. J. (2019). Pediatric equipment. In A practice of anesthesia for infants and children. Elsevier (pp. 1175-1203).
Sessler, D. I., Bloomstone, J. A., Aronson, S., Berry, C., Gan, T. J., Kellum, J. A., & Hamilton, M. (2019). Perioperative quality initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. British journal of anaesthesia, 122(5), 563-574.
Shaikh, K., Shaikh, M., Bhurgri, M. R., Narejo, M. K, & Ahed, J. (2024). Comparison of The Impacts of Administering IV Fluids at Warm Temperatures Versus Normal Temperatures on Core Body Temperature Insurgical Patients. Journal of Population Therapeutics and Clinical Pharmacology 31(4), 905–911. Retrieved from: https://www.jptcp.com/index.php/jptcp/article/view/5569
Shen, C., & He, Y. (2024). Intraoperative hypothermia in patients with laparoscopic surgery: Influencing factors and prevention strategies. Heliyon, 10(10).
Šklebar, I., Bujas, T., & Habek, D. (2019). Spinal anaesthesia-induced hypotension in obstetrics: prevention and therapy. Acta Clinica Croatica, 58(Suppl 1), 90.
Thorburn, P. T., Monteiro, R., Chakladar, A., Cochrane, A., Roberts, J., Hughes, N., & Harper, C. M. (2021). Maternal temperature in emergency caesarean section (MATES): an observational multicentre study. International Journal of Obstetric Anesthesia, 46, 102963.
Tome, R. (2024). Hemodynamic Changes in Elective Cesarean Section, Under Spinal Anesthesia: A Prospective Randomized Controlled Double-Blind Comparison Study with Preoperative Ondansetron Administration. J Surgery, 4(1), 1146.
Wongyingsinn, M., & Pookprayoon, V. (2023). Incidence and associated factors of perioperative hypothermia in adult patients at a university-based, tertiary care hospital in Thailand. BMC anesthesiology, 23(1), 137.
Yang, F., Wang, J., Cui, J., Zhuan, J., Hu, X., & Chen, S. (2022). An overview of the implications for perianesthesia nurses in terms of intraoperative changes in temperature and factors associated with unintentional postoperative hypothermia. Journal of Healthcare Engineering, 2022(1), 6955870.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Brilianti Chrisnajayantie Raden Roro
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
