Scheck Thomas, Kober Alexander, Heigl Peter, Schiller Edeltraud, Buda Peter, Szvitan Gabor, Lieba Frank, Hoerauf Klaus
Universitätsklinik für Anästhesie und Allgemeine Intensivmedizin, Wiener Rotes Kreuz, Bezirksstelle Van Swieten, Forschungsinstitut des Wiener Roten Kreuzes, Wien, Osterreich.
Wien Klin Wochenschr. 2003 Apr 30;115(7-8):259-62. doi: 10.1007/BF03040325.
Infusion of cold fluids in a patient leads to a reduction of core temperature and subsequently worsens hypothermia. We evaluated the efficacy of a newly developed self-warming insulation device for use in pre-hospital rescue.
We studied 50 trauma patients with a rescue time of more than one hour. They were randomly assigned to either infusions taken directly from a warming box in the ambulance (Group A, n = 25) or infusions taken from the warming box and packed in an insulation device (Group B, n = 25). We recorded ambient temperatures, infusion temperatures in five-minute-steps and transport duration of the infusions from the ambulance to the site of accident.
Ambient temperatures and transport duration did not differ significantly between both groups. In Group A the infusion temperature decreased from 36.0 +/- 6.4 degrees C to 19.8 +/- 6.8 degrees C during the transport from the ambulance to the site of accident. In Group B infusion temperature decreased only about 1 degree C. In Group A the temperature of the infusion continued to decrease until the end of measurements. In contrast in Group B the infusion temperature even increased by 0.5 degree C over the measurement period. These differences between the two groups were statistically significant.
Our data show that even pre-warmed infusions from a warming box cool down considerably before they can be given to the patient. A self-warming insulation device can stabilize infusion temperature even under extreme conditions of prehospital trauma care.
给患者输注冷液体可导致核心体温降低,进而使体温过低情况恶化。我们评估了一种新开发的自热保温装置在院前急救中的应用效果。
我们研究了50例救援时间超过1小时的创伤患者。他们被随机分为两组,A组(n = 25)直接输注从救护车上的保温箱取出的液体,B组(n = 25)输注从保温箱取出并装在保温装置中的液体。我们记录了环境温度、每隔5分钟的输注温度以及液体从救护车运输到事故现场的时长。
两组的环境温度和运输时长无显著差异。在A组中,从救护车运输到事故现场的过程中,输注温度从36.0±6.4℃降至19.8±6.8℃。在B组中,输注温度仅下降了约1℃。在A组中,输注温度持续下降直至测量结束。相比之下,在B组中,输注温度在测量期间甚至升高了0.5℃。两组之间的这些差异具有统计学意义。
我们的数据表明,即使是从保温箱中预热过的输注液体,在给患者使用之前也会大幅降温。一种自热保温装置即使在院前创伤护理的极端条件下也能稳定输注温度。