van Eps A W, Orsini J A
University of Queensland, Gatton, Australia.
New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, USA.
Equine Vet J. 2016 Jan;48(1):120-4. doi: 10.1111/evj.12384. Epub 2015 Feb 2.
Digital hypothermia may be effective for laminitis prophylaxis and therapy, but the efficacy of cooling methods used in clinical practice requires evaluation.
To use hoof wall surface temperature (HWST) to compare several cooling methods used in clinical practice.
Experimental crossover design with a minimum washout period of 72 h.
Seven cooling methods (commercially available ice packs, wraps and boots) and one prototypical dry-sleeve device were applied to a single forelimb in 4 horses for 8 h, during which HWST of the cooled forelimb and the uncooled (control) forelimb was recorded hourly. Results were analysed descriptively.
The median (range) HWST from 2-8 h was lowest for the ice and water immersion methods that included the foot and extended proximally to at least include the pastern: 5.2°C (range: 4.8-7.8°C) for the fluid bag and 2.7°C (2.4-3.4°C) for the ice boot. An ice boot that included the distal limb but not the foot resulted in a median HWST of 25.7°C (20.6-27.2°C). Dry interface applications (ice packs) confined to the foot only resulted in a median HWST of 21.5°C (19.5-25.5°C) for the coronet sleeve and 19.8°C (17.6-23°C) for a commercial ice pack. For the dry interface applications that included the foot and distal limb, the median HWST was much higher for the ice pack device, 19.9°C (18.7-23.1°C), compared with the perfused cuff prototype of 5.4°C (4.2-7°C).
Immersion of the foot and at least the pastern region in ice and water achieved sustained HWST <10°C as did a prototype perfused cuff device with a dry interface. Variation between cooling methods may have a profound effect on HWST and therefore efficacy in clinical cases where laminitis prophylaxis or therapy is the goal.
数字式低温疗法可能对预防和治疗蹄叶炎有效,但临床实践中所采用的降温方法的疗效需要评估。
利用蹄壁表面温度(HWST)比较临床实践中使用的几种降温方法。
采用实验性交叉设计,最短洗脱期为72小时。
将七种降温方法(市售冰袋、裹布和蹄靴)以及一种原型干式袖套装置应用于4匹马的单个前肢8小时,在此期间每小时记录降温前肢和未降温(对照)前肢的HWST。对结果进行描述性分析。
在2至8小时期间,包括足部并向近端延伸至少至包括掌部的冰浴和水浴方法的HWST中位数(范围)最低:流体袋为5.2°C(范围:4.8 - 7.8°C),冰靴为2.7°C(2.4 - 3.4°C)。包含远端肢体但不包括足部的冰靴导致HWST中位数为25.7°C(20.6 - 27.2°C)。仅局限于足部的干式界面应用(冰袋),冠状袖套的HWST中位数为21.5°C(19.5 - 25.5°C),市售冰袋为19.8°C(17.6 - 23°C)。对于包括足部和远端肢体的干式界面应用,冰袋装置的HWST中位数为19.9°C(18.7 - 23.1°C),相比之下,灌注袖套原型为5.4°C(4.2 - 7°C),要高得多。
将足部以及至少掌部区域浸入冰和水中可使HWST持续低于10°C,具有干式界面的原型灌注袖套装置也能达到这一效果。在以预防或治疗蹄叶炎为目标的临床病例中,降温方法的差异可能会对HWST进而对疗效产生深远影响。