Kjellman Britt-Marie, Fredrikson Mats, Glad-Mattsson Gunilla, Sjöberg Folke, Huss Fredrik Rm
The Burn unit, Dept, of Plastic Surgery, Hand Surgery and Burns, University Hospital of Linköping, Linköping, Sweden.
Ann Surg Innov Res. 2011 Jul 7;5(1):4. doi: 10.1186/1750-1164-5-4.
Hypothermia in burns is common and increases morbidity and mortality. Several methods are available to reach and maintain normal core body temperature, but have not yet been evaluated in critical care for burned patients. Our unit's ordinary technique for controlling body temperature (Bair Hugger®+ radiator ceiling + bed warmer + Hotline®) has many drawbacks e.g.; slow and the working environment is hampered.The aim of this study was to compare our ordinary heating technique with newly-developed methods: the Allon™2001 Thermowrap (a temperature regulating water-mattress), and Warmcloud (a temperature regulating air-mattress).
Ten consecutive burned patients (> 20% total burned surface area and a core temperature < 36.0°C) were included in this prospective, randomised, comparative study. Patients were randomly exposed to 3 heating methods. Each treatment/measuring-cycle lasted for 6 hours. Each heating method was assessed for 2 hours according to a randomised timetable. Core temperature was measured using an indwelling (bladder) thermistor. Paired t-tests were used to assess the significance of differences between the treatments within the patients. ANOVA was used to assess the differences in temperature from the first to the last measurement among all treatments. Three-way ANOVA with the Tukey HSD post hoc test and a repeated measures ANOVA was used in the same manner, but included information about patients and treatment/measuring-cycles to control for potential confounding. Data are presented as mean (SD) and (range). Probabilities of less than 0.05 were accepted as significant.
The mean increase, 1.4 (SD 0.6°C; range 0.6-2.6°C) in core temperature/treatment/measuring-cycle highly significantly favoured the Allon™2001 Thermowrap in contrast to the conventional method 0.2 (0.6)°C (range -1.2 to 1.5°C) and the Warmcloud 0.3 (0.4)°C (range -0.4 to 0.9°C). The procedures for using the Allon™2001 Thermowrap were experienced to be more comfortable and straightforward than the conventional method or the Warmcloud.
The Allon™2001 Thermowrap was more effective than the Warmcloud or the conventional method in controlling patients' temperatures.
烧伤患者体温过低很常见，会增加发病率和死亡率。有几种方法可用于达到并维持正常的核心体温，但尚未在烧伤重症监护中进行评估。我们科室控制体温的常规技术（Bair Hugger®+ 天花板散热器 + 床暖器 + Hotline®）有许多缺点，例如升温缓慢且会干扰工作环境。本研究的目的是将我们的常规加热技术与新开发的方法进行比较：Allon™2001 温控水床垫和 Warmcloud 温控气床垫。
本前瞻性、随机、对照研究纳入了 10 例连续烧伤患者（烧伤总面积 > 20% 且核心体温 < 36.0°C）。患者被随机采用 3 种加热方法。每个治疗/测量周期持续 6 小时。根据随机时间表，每种加热方法评估 2 小时。使用留置（膀胱）热敏电阻测量核心体温。采用配对 t 检验评估患者体内不同治疗方法之间差异的显著性。采用方差分析评估所有治疗方法中第一次测量到最后一次测量的体温差异。采用三因素方差分析和 Tukey HSD 事后检验以及重复测量方差分析，方式相同，但纳入了患者和治疗/测量周期的信息以控制潜在的混杂因素。数据以均值（标准差）和（范围）表示。概率小于 0.05 被视为具有显著性。
与传统方法（0.2(0.6)°C，范围 -1.2 至 1.5°C）和 Warmcloud（0.3(0.4)°C，范围 -0.4 至 0.9°C）相比，Allon™2001 温控水床垫在每个治疗/测量周期使核心体温平均升高 1.4(标准差 0.6°C；范围 0.6 至 2.6°C)，具有高度显著性优势。使用 Allon™2001 温控水床垫的操作比传统方法或 Warmcloud 更舒适、更简便。
在控制患者体温方面，Allon™2001 温控水床垫比 Warmcloud 或传统方法更有效。
