Cheney F W, Posner K L, Caplan R A, Gild W M
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
Anesthesiology. 1994 Apr;80(4):806-10. doi: 10.1097/00000542-199404000-00012.
Prevention of hypothermia is an important aspect of anesthetic management. Methods used for its prevention may, however, cause cutaneous burns. We reviewed the American Society of Anesthesiologists (ASA) Closed Claims Project database to determine if there were recurrent patterns of injury arising from intraoperative warming methods.
The ASA Closed Claims Project database is a collection of closed malpractice claims that have been reviewed in a standardized format. All claims for burns were reviewed.
Among the 3,000 total claims there were 54 burns, of which 28 resulted from materials or devices used to warm patients. Intravenous fluid bags or bottles warmed in an oven and then applied to the patient's skin were responsible for 18 of the 28 (64%) burns associated with warming devices. These burns from intravenous fluid bags or bottles occurred in predominantly healthy (ASA physical status 1-2) young (age 38 +/- 17 yr, mean +/- standard deviation) women undergoing routine gynecologic or peripheral orthopedic surgery under general anesthesia. Of the eight burns from electrically powered warming equipment, five resulted from circulating-water mattresses.
Intravenous fluid bags or bottles warmed in an operating room oven represent a hazard to anesthetized patients. Because intravenous fluid bags or bottles are not an efficient method of patient warming, there seems to be little justification for their use.
预防体温过低是麻醉管理的一个重要方面。然而，用于预防的方法可能会导致皮肤烧伤。我们回顾了美国麻醉医师协会（ASA）的闭合性索赔项目数据库，以确定术中升温方法是否存在反复出现的损伤模式。
ASA闭合性索赔项目数据库收集了已按标准化格式审查的闭合性医疗事故索赔。对所有烧伤索赔进行了审查。
在总共3000项索赔中，有54起烧伤，其中28起是由用于给患者升温的材料或设备引起的。在烤箱中加热后再敷于患者皮肤上的静脉输液袋或输液瓶导致了28起与升温设备相关的烧伤中的18起（64%）。这些由静脉输液袋或输液瓶引起的烧伤主要发生在健康状况良好（ASA身体状况1 - 2级）的年轻女性（年龄38 ± 17岁，平均值 ± 标准差）身上，她们在全身麻醉下接受常规妇科或外周骨科手术。在8起因电动升温设备导致的烧伤中，有5起是由循环水床垫引起的。
在手术室烤箱中加热的静脉输液袋或输液瓶对麻醉患者构成了一种危害。由于静脉输液袋或输液瓶并非给患者升温的有效方法，使用它们似乎没有什么正当理由。
