预加温对降低脑动脉瘤血管内栓塞术中体温过低的疗效。
The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms.
作者信息
Shin Keun Man, Ahn Jung Hwan, Kim Il Seok, Lee Jong Young, Kang Sang Soo, Hong Sung Jun, Chung Hyun Mo, Lee Hee Jae
机构信息
Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, 150, Sungan-ro, Gangdong-gu, Seoul, 134-701 South Korea.
Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam, South Korea.
出版信息
BMC Anesthesiol. 2015 Jan 21;15(1):8. doi: 10.1186/1471-2253-15-8. eCollection 2015.
BACKGROUND
The anesthetic management of patients undergoing endovascular treatment of cerebral aneurysms in the interventional neuroradiology suite can be challenged by hypothermia because of low ambient temperature for operating and maintaining its equipments. We evaluated the efficacy of skin surface warming prior to induction of anesthesia to prevent the decrease in core temperature and reduce the incidence of hypothermia.
METHODS
Seventy-two patients were randomized to pre-warmed and control group. The patients in pre-warmed group were warmed 30 minutes before induction with a forced-air warming blanket set at 38°C. Pre-induction tympanic temperature (Tpre) was measured using an infrared tympanic thermometer and core temperature was measured at the esophagus immediately after intubation (T0) and recorded at 20 minutes intervals (T20, T40, T60, T80, T100, and T120). The number of patients who became hypothermic at each time was recorded.
RESULTS
Tpre in the control and pre-warmed group were 36.4 ± 0.4°C and 36.6 ± 0.3°C, whereas T0 were 36.5 ± 0.4°C and 36.6 ± 0.2°C. Core temperatures in the pre-warmed group were significantly higher than the control group at T20, T40, T60, T80, T100, and T120 (P < 0.001). Compared to T0, core temperatures at each time were significantly lower in both two groups (P = 0.007 at T20 in pre-warmed group, P < 0.001 at the other times in both groups). The incidence of hypothermia was significantly lower in the pre-warmed group than the control group from T20 to T120 (P = 0.002 at T20, P < 0.001 at the other times).
CONCLUSION
Pre-warming for 30 minutes at 38°C did not modify the trends of the temperature decrease seen in the INR suite. It just slightly elevated the beginning post intubation base temperature. The rate of decrease was similar from T20 to T120. However, pre-warming considerably reduced the risk of intraprocedural hypothermia.
TRIAL REGISTRATION
Clinical Research Information Service (CRiS) Identifier: KCT0001320. Registered December 19th, 2014.
背景
由于介入神经放射学手术室的环境温度较低以及设备维护需求，接受脑动脉瘤血管内治疗的患者在麻醉管理中可能会面临体温过低的挑战。我们评估了麻醉诱导前皮肤表面升温对预防核心体温下降及降低体温过低发生率的效果。
方法
72例患者被随机分为预升温组和对照组。预升温组患者在诱导前30分钟使用设定为38°C的强制空气升温毯进行升温。使用红外鼓膜温度计测量诱导前鼓膜温度（Tpre），并在插管后立即在食管处测量核心体温（T0），并每隔20分钟记录一次（T20、T40、T60、T80、T100和T120）。记录每次体温过低的患者数量。
结果
对照组和预升温组的Tpre分别为36.4±0.4°C和36.6±0.3°C，而T0分别为36.5±0.4°C和36.6±0.2°C。预升温组在T20、T40、T60、T80、T100和T120时的核心体温显著高于对照组（P<0.001）。与T0相比，两组在各个时间点的核心体温均显著降低（预升温组在T20时P=0.007，两组在其他时间点P<0.001）。从T20到T120，预升温组的体温过低发生率显著低于对照组（T20时P=0.002，其他时间点P<0.001）。
结论
在38°C下预升温30分钟并未改变介入神经放射学手术室中观察到的体温下降趋势。它只是略微提高了插管后的起始基础体温。从T20到T120，下降速率相似。然而，预升温显著降低了术中体温过低的风险。
试验注册
临床研究信息服务（CRiS）标识符：KCT0001320。于2014年12月19日注册。
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