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围手术期体温过低管理策略:升温技术进展及临床意义:一篇叙述性综述

Strategies for perioperative hypothermia management: advances in warming techniques and clinical implications: a narrative review.

作者信息

Ji Nan, Wang Jiangtao, Li Xiaohui, Shang Yi

机构信息

Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.

Second Clinical Medical College, Lanzhou University, Lanzhou, China.

出版信息

BMC Surg. 2024 Dec 30;24(1):425. doi: 10.1186/s12893-024-02729-0.

Abstract

Perioperative hypothermia is a frequent clinical complication resulting from the cold environment of the operating room and prolonged skin exposure, leading to adverse outcomes and increased healthcare burdens. To address this issue, this narrative review discusses in detail the currently common warming strategies for perioperative hypothermia .Forced air warming (FAW) systems are widely recognized as the most effective intervention for maintaining core body temperature. Additionally, alternative technologies, such as circulating-water mattresses, carbon-fiber resistive heating systems, self-regulated heated air garments, self-heating blankets, and chemical heat packs, offer diverse advantages and disadvantages. Passive warming methods, including thermal reflective blankets and cotton blankets, provide a cost-effective solution, albeit with reduced efficacy compared to active warming measures. Recent advancements have focused on improving both active and passive warming approaches to balance effectiveness and cost-efficiency. While FAW remains the gold standard, other systems offer specific benefits, such as improved portability and reduced costs, making them suitable for use in diverse clinical scenarios. Effective perioperative temperature management reduces hypothermia-related complications, decreases healthcare expenditures, and provides substantial social and organizational benefits. Thus, selecting the most appropriate warming intervention in clinical practice requires a tailored approach, considering both patient-specific needs and resource availability.

摘要

围手术期体温过低是一种常见的临床并发症,由手术室的寒冷环境和皮肤长时间暴露所致,会导致不良后果并增加医疗负担。为解决这一问题,本叙述性综述详细讨论了当前针对围手术期体温过低的常见升温策略。强制空气升温(FAW)系统被广泛认为是维持核心体温最有效的干预措施。此外,循环水床垫、碳纤维电阻加热系统、自调节加热空气衣物、自热毯和化学热敷袋等替代技术各有优缺点。包括热反射毯和棉被在内的被动升温方法提供了一种经济有效的解决方案,尽管与主动升温措施相比效果有所降低。最近的进展集中在改进主动和被动升温方法,以平衡有效性和成本效益。虽然FAW仍然是金标准,但其他系统也有特定优势,如便携性提高和成本降低,使其适用于各种临床场景。有效的围手术期体温管理可减少与体温过低相关的并发症,降低医疗支出,并带来重大的社会和组织效益。因此,在临床实践中选择最合适的升温干预措施需要一种量身定制的方法,同时考虑患者的特定需求和资源可用性。

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Three dimensional models of human thermoregulation: A review.人体体温调节的三维模型:综述。
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