Weyland W, Weyland A, Hellige G, Fritz U, Neumann H, Martens S, Crozier T, Braun U
Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Germany.
Acta Anaesthesiol Scand. 1994 Aug;38(6):601-6. doi: 10.1111/j.1399-6576.1994.tb03959.x.
Effective rewarming devices have only become available recently. This investigation compares the efficiency of an new overhead radiant heater (ARAGONA Thermal Ceilings TM, CTCX, 1000 W) with that of an electric blanket (50 W) or a standard hospital blanket. 35 patients undergoing postoperative assisted ventilation and continued sedation were randomly assigned to one of the treatments. Shivering, oxygen uptake, heart rate and invasive blood pressure were measured and the increase in total body heat minus body heat production was calculated as heat balance. Results are given as medians (range). Subcutaneous temperatures were taken to calculate the mean skin temperature. The evaluation was undertaken for an oesophageal temperature interval of 35 degrees to 37 degrees C. All groups exhibited a similar mean oxygen uptake i.e. thermogenesis (3.5 (2.7-4.0) ml.kg-1.min-1, 3.3 (2.7-4.9) ml.kg-1.min-1;3.2 (2.4-5.1) ml.kg-1. min-1) which correspond to a resting energy expenditure. The time of rewarming of the radiant heat treated group (n = 12) (100 (76-143) min) for this interval was significantly reduced in comparison to both other groups (183 (116-320) min; 231 (115-340) min). A slightly positive heat balance was only achieved in the group treated by radiant heat, indicating that all metabolic heat was conserved or heat losses were compensated by transfer of external heat. Shivering was significantly reduced in the radiant heater group whereas the rate pressure product was insignificantly higher. We did not find any significant effect for the electric heating blanket in comparison to the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
有效的复温设备直到最近才出现。本研究比较了一种新型头顶辐射加热器(ARAGONA热天花板TM,CTCX,1000瓦)与电热毯(50瓦)或标准医院毛毯的效率。35例接受术后辅助通气和持续镇静的患者被随机分配到其中一种治疗方法中。测量了寒战、氧摄取、心率和有创血压,并计算全身热量增加减去身体热量产生作为热平衡。结果以中位数(范围)表示。测量皮下温度以计算平均皮肤温度。在食管温度35摄氏度至37摄氏度的区间内进行评估。所有组的平均氧摄取即产热相似(3.5(2.7 - 4.0)毫升·千克-1·分钟-1,3.3(2.7 - 4.9)毫升·千克-1·分钟-1;3.2(2.4 - 5.1)毫升·千克-1·分钟-1),这与静息能量消耗相对应。与其他两组(183(116 - 320)分钟;231(115 - 340)分钟)相比,该区间内辐射热治疗组(n = 12)的复温时间(100(76 - 143)分钟)显著缩短。只有辐射热治疗组实现了轻微的正热平衡,这表明所有代谢热都得以保存或外部热量传递补偿了热量损失。辐射加热器组的寒战明显减少,而心率血压乘积略高但无显著差异。与对照组相比,我们未发现电热毯有任何显著效果。(摘要截短至250字)