Childs C, Little R A
North Western Injury Research Centre, University of Manchester.
Arch Dis Child. 1994 Jul;71(1):31-4. doi: 10.1136/adc.71.1.31.
This study describes the pattern of oxygen consumption (VO2), rectal temperature (Tr), and acral skin temperature (Tac) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VO2 and carbon dioxide production (VCO2)) were made using an open circuit, flow through system of indirect calorimetry. Tr and Tac were monitored continuously. Sixteen patients were studied during the first 18 hours after being burned. Three phases of change in VO2, Tr, and Tac are described. The first was a stable period and there was little change from admission values. The second (7-10 hours after burn) was a phase of rapid heat storage. It started with a fall in Tac. Peak values of Tr (38.8-41.1, median 40.0 degrees C) and VO2 (8.5-11.8 ml/min/kg) occurred either in phase 2 or in the later phase 3. At its peak VO2 was 12-61% above values in phase 1. In phase 3, Tac returned towards admission values but Tr and VO2 were variable. These changes suggest that both an increase in metabolic heat production as well as heat conservation at the extremities may be involved in the generation of early fever after a burn.
本研究描述了在热中性环境中护理的烧伤儿童睡眠和静息（清醒）状态下的耗氧量（VO2）、直肠温度（Tr）和肢端皮肤温度（Tac）模式。使用间接量热法的开路流通系统测量呼吸气体交换（VO2和二氧化碳产生量（VCO2））。持续监测Tr和Tac。在烧伤后的前18小时内对16名患者进行了研究。描述了VO2、Tr和Tac变化的三个阶段。第一个阶段是稳定期，与入院时的值相比变化很小。第二个阶段（烧伤后7 - 10小时）是快速蓄热阶段。它始于Tac下降。Tr（38.8 - 41.1，中位数40.0℃）和VO2（8.5 - 11.8 ml/min/kg）的峰值出现在第2阶段或稍后的第3阶段。VO2峰值比第1阶段的值高出12% - 61%。在第3阶段，Tac恢复到接近入院时的值，但Tr和VO2变化不定。这些变化表明，代谢产热增加以及肢体的热量保存可能都与烧伤后早期发热的产生有关。
