Effectiveness of Perioperative Warming Interventions for Preventing and Managing Hypothermia in Adult Surgical Patients: A Literature Review

Ni Luh Gede Eka Wahyuni Sudiarsa (Institut Teknologi dan Kesehatan Bali, Denpasar, Indonesia)
Ni Putu Kamaryati (Institut Teknologi dan Kesehatan Bali, Denpasar, Indonesia)
I Nengah Adiana Adiana (Institut Teknologi dan Kesehatan Bali, Denpasar, Indonesia)
Ni Komang Tri Agustini (Institut Teknologi dan Kesehatan Bali, Denpasar, Indonesia)

Babali Nursing Research
Vol. 7 No. 4 (2026): October

Introduction: Perioperative hypothermia is a common complication associated with impaired thermoregulation during anesthesia and surgery, potentially increasing the risk of bleeding, surgical site infections, postoperative shivering, and delayed recovery. Various warming interventions have been investigated, but their comparative effectiveness remains uncertain. Objective: To synthesize evidence on the effectiveness of warming interventions in maintaining body temperature and preventing hypothermia in adult surgical patients during the perioperative period. Methods: A systematic literature review was conducted using PubMed, Google Scholar, and ScienceDirect to identify studies published between 2016 and 2026. Studies were selected according to predefined eligibility criteria, and the selection process was reported in accordance with the PRISMA guidelines. Fourteen primary studies were included and synthesized narratively according to intervention type, clinical outcomes, and methodological limitations. Results: The 14 studies were categorized into prewarming (n = 5), external warming (n = 6), and fluid warming or comparative interventions (n = 3). Forced-air warming and prewarming generally reduced hypothermia incidence and improved perioperative temperature maintenance, findings supported by several randomized controlled trials. External warming and warmed intravenous fluids also demonstrated favorable temperature outcomes in specific clinical settings. However, some comparisons showed nonsignificant results, and differences in study designs, patient populations, intervention protocols, and outcome measurements limited direct comparisons. Evidence regarding combined warming strategies remained limited. Conclusion: Active warming interventions generally support perioperative temperature management, although their effectiveness varies across clinical contexts. Further high-quality studies evaluating combined external warming and warmed intravenous fluids are needed to establish optimal hypothermia prevention strategies.