The Center for Prehospital Medicine, Carolinas Medical Center, Charlotte, NC, USA.
Acad Emerg Med. 2012 Nov;19(11):1309-12. doi: 10.1111/acem.12006.
Inducing therapeutic hypothermia using chilled saline in resuscitated cardiac arrest patients has been shown to be feasible and effective. Limited research exists assessing the efficiency of this cooling method. The objective of this study was to assess the change in temperature of 4°C saline upon exiting an infusion set in the laboratory setting while varying conditions of fluid delivery.
Efficiency was studied by assessing change in fluid temperature (°C) during the infusion under four laboratory conditions. Each condition was performed four times using 1-L bags of normal saline. Fluid was infused into a 1000-mL beaker through 10 gtt/mL tubing. Flow rate was controlled using a tubing clamp and in-line transducer with a flow meter, while temperature was continuously monitored in a side port at the terminal end of the intravenous (IV) tubing using a digital thermometer. The four conditions included different insulation methods. Descriptive statistics and analysis of variance were performed to assess changes in fluid temperature.
The mean (±SD) fluid temperature at time 0 was 3.2°C (95% confidence interval [CI] = 3.0 to 3.4 °C) with no significant difference in starting temperature between groups (p = 0.45). When flow rate was constant, it was determined that fluid temperatures were significantly cooler when infused using a chilled, gel-filled sleeve around the saline bag (p < 0.006).
In a laboratory setting, the most efficient method of infusing cold fluid appears to be a method that both keeps the bag of fluid insulated and infused at a faster rate.
在复苏后心脏骤停患者中使用冷却盐水诱导治疗性低温已被证明是可行和有效的。目前关于这种冷却方法的效率的研究有限。本研究的目的是评估在实验室环境中不同输液条件下,4°C 生理盐水从输液套装中流出时的温度变化。
通过在实验室的四种条件下评估输液过程中液体温度(°C)的变化来研究效率。每个条件均使用 1-L 袋生理盐水重复四次。通过 10 gtt/mL 管将液体输注到 1000-mL 烧杯中。使用管夹和在线换能器与流量计控制流速,同时使用数字温度计在静脉(IV)管末端的侧端口连续监测温度。四种条件包括不同的保温方法。采用描述性统计和方差分析评估液体温度的变化。
在时间 0 时,液体的平均(±SD)温度为 3.2°C(95%置信区间 [CI] = 3.0 至 3.4°C),组间起始温度无显著差异(p = 0.45)。当流速恒定时,确定当使用冷藏的、充满凝胶的套管围绕盐水袋输注时,液体温度明显更低(p < 0.006)。
在实验室环境中,输注冷液的最有效方法似乎是一种既能保持液体袋隔热又能更快输注的方法。