Department of Medicine, Division of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St Petersburg, FL; Department of Anesthesiology and Critical Care, Division of Pediatric Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Transport Medicine, Johns Hopkins All Children's Hospital, St Petersburg, FL.
Air Med J. 2021 Jan-Feb;40(1):65-68. doi: 10.1016/j.amj.2020.10.002. Epub 2020 Oct 22.
We sought to describe the degree of temperature elevation (∆T) among children transported in a subtropical climate (Florida) via fixed wing aircraft and identify potential relationships between patient weight and ∆T.
We performed a retrospective cohort study in children < 18 years of age undergoing interfacility transport via fixed wing aircraft from January 2016 through July 2020. The study outcomes were ∆T, maximum patient temperature, ambient temperature, and heat index. Bivariate cohorts defined by patient weight (5 kg) were compared using Fisher exact, Student t-, and Wilcoxon rank sum analyses. Exploratory testing included receiver operator characteristic curve analyses and unadjusted logistic regression.
Of the 58 children studied, 25 (43%) were ≤ 5 kg, and 33 (57%) were > 5 kg. Compared with children > 5 kg, those ≤ 5 kg had greater ∆T (0.8° ± 0.6°C vs. 0.2° ± 0.3°C), maximum patient temperature (37.3° ± 0.6°C vs. 36.8° ± 0.4°C), and proportion with ≥ 1°C ∆T (36% vs. 3%). No child > 5 kg had a temperature > 38°C, and no differences were observed for heat index or ambient temperature. Receiver operating characteristic analysis of patient weight on ∆T ≥ 1°C yielded an area under the curve of 0.86 (cutoff of 3.5 kg; sensitivity = 81.3%, specificity = 80%). Patient weight was inversely associated with ∆T ≥ 1°C (odds ratio = 0.69; 95% confidence interval, 0.49-0.96).
Young children appear at greatest risk for developing environmental hyperthermia during interfacility fixed wing transport.
我们旨在描述在亚热带气候（佛罗里达州）通过固定翼飞机转运的儿童的体温升高程度（∆T），并确定患者体重与∆T之间的潜在关系。
我们对 2016 年 1 月至 2020 年 7 月期间通过固定翼飞机进行院内转运的<18 岁儿童进行了回顾性队列研究。研究结果为∆T、患者最高体温、环境温度和热指数。使用 Fisher 精确检验、学生 t 检验和 Wilcoxon 秩和检验比较按患者体重（5kg）定义的双变量队列。探索性检验包括接受者操作特征曲线分析和未调整的逻辑回归。
在 58 名研究儿童中，25 名（43%）体重≤5kg，33 名（57%）体重>5kg。与体重>5kg的儿童相比，体重≤5kg的儿童∆T 更高（0.8°C±0.6°C 与 0.2°C±0.3°C）、患者最高体温更高（37.3°C±0.6°C 与 36.8°C±0.4°C），以及体温升高≥1°C的比例更高（36%与 3%）。没有体重>5kg的儿童体温>38°C，热指数或环境温度没有差异。患者体重对∆T≥1°C 的受试者工作特征分析曲线下面积为 0.86（截断值为 3.5kg；敏感性为 81.3%，特异性为 80%）。患者体重与∆T≥1°C 呈负相关（比值比=0.69；95%置信区间，0.49-0.96）。
在院内固定翼转运过程中，幼儿似乎面临着发生环境性高热的最大风险。
