Education and Safety in Transfusion (QUEST) Research Program, University of Toronto Quality in Utilization, Toronto, ON, Canada.
Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room H1 71, Toronto, ON, M4N 3M5, Canada.
Eur J Trauma Emerg Surg. 2024 Oct;50(5):2289-2294. doi: 10.1007/s00068-024-02612-w. Epub 2024 Aug 7.
Massively bleeding trauma patients often arrive to intensive care units hypothermic. Active warming blankets have shown promise in reducing hypothermia in the pre-hospital setting, but less is known about their in-hospital use. The aim of this pilot evaluation was to understand the feasibility of the Ready-Heat blanket in a level 1 trauma centre to improve the management of hypothermia in massively bleeding trauma patients.
This was a prospective, observational, feasibility study of 15 patients performed at a single level 1 trauma centre. Patients were eligible for enrollment if they presented to the trauma bay and a massive hemorrhage protocol was activated. Primary outcome measures (feasibility) included: blanket applied to the patient; temperature recording in the trauma bay, and next phase or final phase of care; and blanket remaining on patient upon arrival to the subsequent phase of care.Secondary outcome measures (safety) included skin irritation and cold discomfort. Use of the Ready-Heat blanket was considered feasible if 10 of 15 patients met all four criteria for feasibility.
The Ready-Heat blanket was placed on all patients with mean time to blanket application of 24 (± 13.4) minutes. Thirteen patients (86.7%) met all four criteria for feasibility. Initial challenges were identified in the first five patients including proper blanket application, keeping the blanket on the patient through subsequent phases of care, and failure to obtain temperature recordings.
The Ready-Heat blanket proves feasible for this patient population. A larger study focusing on hypothermia prevention and treatment is warranted.
NCT04399902.
May 22, 2020.
大量出血的创伤患者在到达重症监护室时经常会出现低体温。主动加热毯在院前环境中降低低体温方面显示出了一定的前景,但对于其在院内的使用知之甚少。本试验评估的目的是了解 Ready-Heat 毯在 1 级创伤中心的可行性,以改善大量出血性创伤患者低体温的管理。
这是一项在一家 1 级创伤中心进行的前瞻性、观察性可行性研究。如果患者到达创伤室且激活了大量出血方案,则有资格入组。主要结局指标(可行性)包括:毯子应用于患者;创伤室的温度记录,以及下一阶段或最终阶段的治疗;以及毯子在患者到达下一阶段的治疗时仍留在患者身上。次要结局指标(安全性)包括皮肤刺激和寒冷不适。如果 15 名患者中有 10 名满足所有四项可行性标准,则认为 Ready-Heat 毯的使用是可行的。
所有患者均使用 Ready-Heat 毯子,毯子应用的平均时间为 24 分钟(±13.4)。13 名患者(86.7%)满足所有四项可行性标准。在最初的 5 名患者中发现了一些初始挑战,包括正确的毯子应用、在随后的治疗阶段保持毯子在患者身上以及未能获得体温记录。
Ready-Heat 毯适用于该患者群体。需要进行一项更大的研究,重点关注预防和治疗低体温。
NCT04399902。
2020 年 5 月 22 日。