Critical appraisal of the article with evidence based practice

Critical Appraisal
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The aim of the study in the article encompasses an evaluation of the performance of various timelines of the active preoperative warming of patients to prevent the risk occurrence of hypothermia. The study followed a case-control research design as two different groups of patients were compared according to their exposure and non-exposure to a given factor that was highly likely to affect the outcome of the study.
The population of the study was assigned amongst 200 patients who had surgeries scheduled for an estimated maximum of 90 minutes (Horn et al., 2012). The patients were first split into two groups. The prewarmed and the non-prewarmed group. These groups were also sectioned into smaller groups for the application of the study design. The prewarmed group of patients had been passively insulated for skin surface warming for a maximum of 30 minutes before their surgeries (Horn et al., 2012).
The levels of shivering of the patients were graded through the visual inspection, and there were critical differences in the alterations of the core temperatures between the non-prewarmed group of patients and the prewarmed group of patients. Regarding the prewarmed groups, the study outcome indicates zero changes in the core temperatures of the patients during surgery. 69% of the patients who were not insulated prior their surgery suffered from hypothermia (Horn et al., 2012). Shivering was also observed in 10 of the patients who had been pre-warmed before their operations.

The outcome of the study reports that prewarming patients for an average of 10- 20 minutes does reduce the chances of shivering and mostly prevents the risk occurrence of hypothermia (Horn et al., 2012).
Prewarming in other similar study cases had resulted in uncomfortable sweating of the patients. The methods of prewarming also have to cover a wider skin surface to ensure heat transfer of to the core tissues to ensure accuracy. This study might have failed to include patients who did not undergo open surgeries in the laparoscopy. However, this factor is covered as the patients in the study could be compared to patients who underwent open abdominal surgeries. The patients who were already hypothermic had a higher risk of developing hypothermia before their operation. The actual heat content of the patients before the warming practice was also not measured which indicates the likelihood of obtaining inaccurate results. More so, the study could have biased the distribution of different surgeries across the groups which were unequal. This factor hints that the results might have been majorly influenced by the laparoscopic surgery patients in the groups that were prewarmed for 20 -30 minutes.
Reference
Horn, E., Bein, B., Böhm, R., Steinfath, M., Sahili, N., & Höcker, J. (2012). The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia, 67(6), 612-617. http://dx.doi.org/10.1111/j.1365-2044.2012.07073.x