Efficacy of an Intelligent Closed-Loop Warming System in Preventing Perioperative Hypothermia and Improving Recovery in Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial

Purpose: To evaluate the efficacy of an intelligent closed-loop warming system compared with conventional warming methods in preventing perioperative hypothermia and improving postoperative recovery in patients undergoing video-assisted thoracoscopic surgery (VATS). Patients and Methods: A total of 118 adult patients scheduled for elective VATS were randomly assigned to the conventional warming group (n = 59) or the intelligent closed-loop warming group (n = 59). Conventional warming management employed an underbody warming blanket, supplemented with blood and fluid warming when core temperature fell below 36.0°C. The intelligent closed-loop warming system utilized wireless sensors and an automated feedback-controlled warming unit to maintain core temperature between 36.5°C and 37.0°C. Core temperature was continuously monitored from anesthesia induction to post-anesthesia care unit (PACU) discharge. The primary outcome was the incidence of perioperative hypothermia (core temperature < 36.0°C). Secondary outcomes included mean and minimum intraoperative temperature, extubation time, PACU temperature, postoperative complications, length of hospital stay (HLOS), and hospitalization cost. Results: Perioperative hypothermia occurred in significantly fewer patients in the intelligent group than in the conventional group (25.4% vs. 76.3%, p < 0.001). The intelligent closed-loop warming system maintained higher mean (36.40 ± 0.33°C vs. 35.96 ± 0.45°C, p < 0.001) and minimum (36.09 ± 0.35°C vs. 35.58 ± 0.58°C, p < 0.001) core temperatures. Extubation time was shorter (5.12 ± 2.31 min vs. 9.69 ± 8.27 min, p < 0.001), PACU temperature was higher ( p = 0.001), postoperative fever incidence was lower (0% vs. 13.6%, p = 0.006), and HLOS was reduced (10.02 ± 3.87 vs. 11.63 ± 4.25 days, p = 0.034). No significant differences were observed in infection rate or hospitalization cost. Conclusion: The intelligent closed-loop warming system effectively prevents perioperative hypothermia and enhances postoperative recovery in VATS patients. It provides precise thermal regulation and better clinical outcomes, supporting its application in perioperative temperature management.