Winslow E H, Lane L D, Gaffney F A
Nurs Res. 1985 May-Jun;34(3):164-9.
Physiological responses before, during, and after three types of baths were determined in 18 patients who were 5 to 17 days postinfarction and 22 control adults. In the patients, oxygen consumption (VO2) averaged 6, 7, and 7 ml/kg/min, peak heart rate 105, 108, and 112 beats per minute, and rate pressure product 115, 120, and 111 for basin, tub, and shower bathing, respectively. Oxygen consumption during bathing was less than 3 times resting levels. The patients had a significantly lower VO2 during bathing than the control subjects. The patients' peak heart rates were higher than anticipated for the level of exertion, and sometimes exceeded the target heart rates used in predischarge testing. Peak heart rate and occurrence of dysrhythmia did not differ significantly between the three types of baths. In the women patients, rate pressure product was significantly higher after tub bath than after basin bath or shower. The subjects had no cardiovascular symptoms during bathing, rated all three baths as light exertion, and disliked the basin bath. The data show that the physiologic costs of the three types of baths are similar, differences in responses to bathing seem more a function of subject variability than bath type, and many cardiac patients can take a tub bath or shower earlier in their hospitalization. However, more research is needed to predict patients likely to have an exaggerated response to bathing and to develop clear guidelines for bath method selection and progression.
对18例心肌梗死后5至17天的患者和22名对照成年人，测定了三种类型沐浴前、沐浴期间和沐浴后的生理反应。患者的耗氧量（VO2）在盆浴、浴缸浴和淋浴时分别平均为6、7和7毫升/千克/分钟，最高心率分别为每分钟105、108和112次，心率血压乘积分别为115、120和111。沐浴期间的耗氧量低于静息水平的3倍。患者沐浴期间的VO2显著低于对照受试者。患者的最高心率高于预期的运动水平，有时超过出院前测试所用的目标心率。三种类型的沐浴之间，最高心率和心律失常的发生率没有显著差异。在女性患者中，浴缸浴后的心率血压乘积显著高于盆浴或淋浴后。受试者在沐浴期间没有心血管症状，将所有三种沐浴都评为轻度运动，并表示不喜欢盆浴。数据表明，三种类型沐浴的生理消耗相似，对沐浴反应的差异似乎更多地取决于个体差异而非沐浴类型，许多心脏病患者在住院早期可以进行浴缸浴或淋浴。然而，需要更多的研究来预测可能对沐浴有过度反应的患者，并制定明确的沐浴方法选择和进展指南。
