Suppr超能文献

院前低温对严重烧伤患者预后的影响。

Impact of Prehospital Hypothermia on the Outcomes of Severely Burned Patients.

作者信息

Ehrl Denis, Heidekrueger Paul I, Rubenbauger Johannes, Ninkovic Milomir, Broer P Niclas

机构信息

Hand Surgery, Ludwig-Maximilians-University, Munich, Germany.

Plastic Surgery, Ludwig-Maximilians-University, Munich, Germany.

出版信息

J Burn Care Res. 2018 Aug 17;39(5):739-743. doi: 10.1093/jbcr/irx033.

Abstract

When treating burn injuries, to date, there still remains significant disagreement whether presence of hypothermia (HT) on burn centers' intensive care unit (BICU) admission improves or worsens outcomes. The presented single burn center experiences set out to further evaluate the incidence, cause, and potential effects of HT on outcomes in severely burned patients. Between January 2015 and February 2017, 142 severely burned patients were admitted to a BICU. Temperature at BICU admission of <36.0°C was defined as HT and ≥36.0°C as normothermia (NT). The cases were divided into two groups: HT vs NT. Fifty-four patients met inclusion criteria and were analyzed retrospectively regarding encountered complications, time of hospitalization, and overall survival. The overall incidence of HT on arrival was 62.9%. Mean duration from burn accident to BICU admission did not differ significantly, but the groups showed significant differences regarding total body surface area (TBSA; P < .05). Both groups showed a similar distribution, regarding number of surgeries, duration until first burn excision, length of ventilation, and mortality rate of patients (P > .05). However, time until death was significantly shorter in the HT group. HT at admission remains a common problem following burn injury. Main risk factors include inappropriate temperature management after injury and during transport, extent of TBSA burn, and quantity of resuscitation. Given the high incidence, the involved health care and, especially, also prehospital providers should be further educated about existing recommendations and guidelines to prevent HT.

摘要

在治疗烧伤时,迄今为止,对于烧伤中心重症监护病房(BICU)收治时出现体温过低(HT)是改善还是恶化预后,仍存在重大分歧。本文介绍的单一烧伤中心的经验旨在进一步评估HT在严重烧伤患者中的发生率、原因及其对预后的潜在影响。2015年1月至2017年2月期间,142例严重烧伤患者被收治入BICU。将BICU收治时体温<36.0°C定义为HT,≥36.0°C定义为正常体温(NT)。病例分为两组:HT组和NT组。54例患者符合纳入标准,对其遇到的并发症、住院时间和总体生存率进行回顾性分析。到达时HT的总体发生率为62.9%。从烧伤事故到BICU收治的平均时长无显著差异,但两组在烧伤总面积(TBSA)方面存在显著差异(P<.05)。两组在手术次数、首次烧伤清创时间、通气时长和患者死亡率方面分布相似(P>.05)。然而,HT组的死亡时间明显更短。烧伤后收治时出现HT仍是一个常见问题。主要危险因素包括受伤后及转运过程中温度管理不当、TBSA烧伤范围和复苏量。鉴于其高发生率,应进一步对相关医护人员,尤其是院前急救人员进行现有建议和指南的培训,以预防HT。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验