Gregory J S, Bergstein J M, Aprahamian C, Wittmann D H, Quebbeman E J
Section of Trauma and Emergency Surgery, Medical College of Wisconsin, Milwaukee.
J Trauma. 1991 Sep;31(9):1247-51; discussion 1251-2. doi: 10.1097/00005373-199109000-00008.
We developed a new technique, extracorporeal venovenous rewarming (EVR), to rewarm hypothermic patients in the intensive care unit or operating room. We compared this method with the active external (standard) techniques of warming blankets; heated ventilator circuits, intravenous fluids, and gastric and peritoneal lavage; and cardiopulmonary bypass. The EVR technique warmed patients' blood or additional blood products and crystalloids to 40 degrees C at 150-400 mL/min and allowed survival from a core temperature of 31.1 degrees C after massive injury. The EVR technique rewarming patients more rapidly than standard techniques and may be most appropriate in patients with multisystem trauma when rapid correction of hypothermia-related hypovolemia, coagulopathy, and arrhythmia is necessary. Cardiopulmonary bypass is required in severely hypothermic patients with cardiac arrest. Standard techniques can be used when these immediately life-threatening conditions are not present.
我们研发了一种新技术——体外静脉-静脉复温（EVR），用于在重症监护病房或手术室中为体温过低的患者复温。我们将这种方法与使用加热毯的主动外部（标准）技术、加热的呼吸机回路、静脉输液、胃肠及腹膜灌洗以及体外循环进行了比较。EVR技术能以150 - 400毫升/分钟的速度将患者的血液、额外的血液制品和晶体液加热至40摄氏度，并使遭受严重创伤后核心体温为31.1摄氏度的患者存活下来。EVR技术为患者复温的速度比标准技术更快，在多系统创伤患者中，当需要快速纠正与体温过低相关的低血容量、凝血病和心律失常时，该技术可能最为适用。心脏骤停的严重体温过低患者需要进行体外循环。当不存在这些直接危及生命的情况时，可以使用标准技术。
