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空中医疗后送期间三种预防重伤员体温过低策略的比较

Comparison of three strategies for preventing hypothermia in critically injured casualties during aeromedical evacuation.

作者信息

Schmelz Joseph O, Bridges Elizabeth J, Wallace Capt Marlene B, Sanders Scott F, Shaw Timothy, Kester Nurani, Bauer Steve, Sylvester James C

机构信息

59th Clinical Research Squadron, Wilford Hall Medical Center, 2200 Bergquist Drive, Lackland AFB, TX 78236, USA.

出版信息

Mil Med. 2007 Mar;172(3):322-6. doi: 10.7205/milmed.172.3.322.

Abstract

Critically injured patients are at risk for hypothermia. This study determined the efficacy of three hypothermia prevention strategies: the ChillBuster warming blanket, ChillBuster with a reflective blanket, and two wool blankets. A quasi-experimental design was used to compare changes in core temperature. Following resuscitation from hypovolemic shock, 20 swine were assigned to one of the three interventions, placed in an environmental chamber set to reproduce in-flight conditions onboard a military cargo aircraft (50 degrees F/airspeed 0.2 m/s), and monitored for 6 hours. A repeated measures analysis of variance and least-squared difference post hoc were performed. The ChillBuster/reflective blanket group was significantly warmer than the ChillBuster only group and the wool blanket group (p < 0.01). After 6 hours of cold exposure, the ChillBuster/reflective blanket group remained warm while the ChillBuster only and wool blanket groups developed mild hypothermia. Combined use of a warming blanket and reflective blanket was effective in preventing hypothermia over 6 hours and is feasible in a deployed military environment.

摘要

重伤患者有体温过低的风险。本研究确定了三种体温过低预防策略的效果:ChillBuster保暖毯、搭配反射毯的ChillBuster保暖毯以及两条羊毛毯。采用准实验设计来比较核心体温的变化。在从低血容量性休克复苏后,将20头猪分配到三种干预措施中的一种,放置在一个环境舱中,该环境舱设置为模拟军事运输机上的飞行条件(50华氏度/空速0.2米/秒),并监测6小时。进行了重复测量方差分析和事后最小二乘差异分析。ChillBuster/反射毯组明显比仅使用ChillBuster保暖毯组和羊毛毯组更暖和(p < 0.01)。在冷暴露6小时后,ChillBuster/反射毯组仍保持温暖,而仅使用ChillBuster保暖毯组和羊毛毯组出现了轻度体温过低。保暖毯和反射毯联合使用在6小时内有效预防了体温过低,并且在部署的军事环境中是可行的。

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