Giesbrecht G G, Schroeder M, Bristow G K
Laboratory for Exercise and Environmental Medicine, Faculty of Physical Education and Recreation Studies, University of Manitoba, Winnipeg, Canada.
Aviat Space Environ Med. 1994 Sep;65(9):803-8.
Forced-air warming is used for prevention or reversal of hypothermia in surgical patients. In the present study, the efficacy of this system for treatment of immersion hypothermia was evaluated. Six men and two women were twice immersed in 8 degrees C water until hypothermic. They were then rewarmed by either: 1) shivering-only inside a sleeping bag; or 2) forced-air warming. Esophageal and skin temperature, cutaneous heat flux and metabolism were measured. Afterdrop (+/- SD) during forced-air warming (0.43 +/- 0.26 degrees C) was approximately 30% less than during shivering (0.61 +/- 0.26 degrees C) (p < 0.001). Rewarming rate during forced-air warming (3.26 +/- 1.8 degrees C.h-1) was not significantly different from shivering (3.02 +/- 1.2 degrees C.h-1). Skin temperature was higher during forced-air warming by 3.7 degrees C early and 4.5 degrees C after 35 min of warming. Heat production increased by 77 W over the initial 20 min of shivering, and subsequently declined, compared to an immediate decrease with forced-air warming. During shivering heat flux ranged from 30 W early in rewarming, to 50 W after 35 min, compared to -237 W and -163 W respectively, for forced-air warming. Forced-air warming attenuated afterdrop and the metabolic stress of shivering while maintaining an average rate of rewarming comparable to shivering. Forced-air warming is a safe, simple, noninvasive treatment and could be used effectively in an emergency medical facility, and possibly in some rescue/emergency vehicles or marine vessels.
强制空气加温用于预防或逆转外科手术患者的体温过低。在本研究中，评估了该系统治疗浸泡性体温过低的疗效。6名男性和2名女性被两次浸入8摄氏度的水中直至体温过低。然后他们通过以下方式复温：1）仅在睡袋内颤抖；或2）强制空气加温。测量了食管和皮肤温度、皮肤热通量和代谢情况。强制空气加温期间的体温后降（±标准差）（0.43±0.26摄氏度）比颤抖期间（0.61±0.26摄氏度）约低30%（p<0.001）。强制空气加温期间的复温速率（3.26±1.8摄氏度·小时-1）与颤抖期间（3.02±1.2摄氏度·小时-1）无显著差异。在强制空气加温早期，皮肤温度高3.7摄氏度，加温35分钟后高4.5摄氏度。与强制空气加温时立即下降相比，颤抖开始后的最初20分钟内产热增加77瓦，随后下降。在颤抖期间，复温早期热通量范围为30瓦，35分钟后为50瓦，而强制空气加温时分别为-237瓦和-163瓦。强制空气加温减轻了体温后降和颤抖的代谢应激，同时保持了与颤抖相当的平均复温速率。强制空气加温是一种安全、简单、无创的治疗方法，可在紧急医疗设施中有效使用，也可能在一些救援/应急车辆或船舶上使用。
