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心脏手术后复温的疗效。

Efficacy of postoperative rewarming after cardiac surgery.

作者信息

Bräuer Anselm, Weyland Wolfgang, Kazmaier Stephan, Trostdorf Ulf, Textor Zoran, Hellige Gerhard, Braun Ulrich

机构信息

Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Götingen, Göttingen, Germany.

出版信息

Ann Thorac Cardiovasc Surg. 2004 Jun;10(3):171-7.

Abstract

OBJECTIVE

To compare the efficacy of forced-air warmers and radiant heaters on rewarming after cardiac surgery in a prospective randomized study.

METHODS

Fifty male patients who had undergone coronary artery bypass graft surgery were studied. The control group (Gr. C, n=10) was nursed under a standard hospital blanket. Two groups were treated with forced-air warmers: WarmTouch 5700 (Gr. WT, n=10) and Bair Hugger 500 (Gr. BH, n=10). Two other groups were treated by radiant heaters: the Aragona Thermal Ceilings CTC X radiant heater (Gr. TC, n=10) and a self assembled radiant heater of 4 Hydrosun 500 infrared lamps (Gr. HY, n=10). Changes of oesophageal temperature, mean skin temperature, mean body temperature and relative heat balance were calculated from oesophageal temperature, 4 skin temperatures and oxygen consumption (VO(2)).

RESULTS

All actively treated groups with exception of the TC group showed significantly faster oesophageal warming than the control group. The mean body temperature increased 1.1 (0.7-1.7) degrees Ch(-1) in Gr. WT, 1.3 (0.7-1.5) degrees Ch(-1) in Gr. BH, 0.8 (0.5-1.4) degrees Ch(-1) in Gr. TC and 0.7 (0.4-1.0) degrees Ch(-1) in Gr. HY compared to Gr. C with 0.4 (0.2-0.7) degrees Ch(-1). The mean VO(2) and the maxima of the VO(2) during the study period did not differ significantly between the groups.

CONCLUSION

In the current setting active warming, forced-air warming more than radiant warming, increased speed of rewarming two- to threefold in comparison to insulation with a blanket.

摘要

目的

在一项前瞻性随机研究中比较强制空气暖器和辐射加热器对心脏手术后复温的效果。

方法

对50例接受冠状动脉搭桥手术的男性患者进行研究。对照组(C组,n = 10)在标准医院毛毯下护理。两组使用强制空气暖器进行治疗:WarmTouch 5700(WT组,n = 10)和Bair Hugger 500(BH组,n = 10)。另外两组使用辐射加热器进行治疗:Aragona Thermal Ceilings CTC X辐射加热器(TC组,n = 10)和由4个Hydrosun 500红外灯自行组装的辐射加热器(HY组,n = 10)。根据食管温度、4个皮肤温度和耗氧量(VO₂)计算食管温度、平均皮肤温度、平均体温和相对热平衡的变化。

结果

除TC组外,所有积极治疗组的食管复温速度均明显快于对照组。与C组平均每小时升高0.4(0.2 - 0.7)℃相比,WT组平均体温每小时升高1.1(0.7 - 1.7)℃,BH组为1.3(0.7 - 1.5)℃,TC组为0.8(0.5 - 1.4)℃,HY组为0.7(0.4 - 1.0)℃。研究期间各组的平均VO₂和VO₂最大值无显著差异。

结论

在当前情况下,主动复温时,强制空气复温比辐射复温更有效,与使用毛毯保温相比,复温速度提高了两到三倍。

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