Mlcak R P, Desai M H, Robinson E, McCauley R L, Robson M C, Herndon D N
Shriners Burns Institute, Galveston, TX 77550.
J Burn Care Rehabil. 1993 Jul-Aug;14(4):427-30. doi: 10.1097/00004630-199307000-00004.
It has been postulated that because of the extensive destruction of the skin and appendages after thermal injury, the thermoregulatory control mechanism would be impaired, and these patients would be intolerant to prolonged work. Preview studies demonstrate evidence that during work in a hot climate, patients with an extensively healed burn react with an excessive rise in body temperature. This study was designed to investigate the thermoregulatory response to exercise in pediatric patients with burns and to study changes in body temperature during exercise testing. Cardiopulmonary stress tests were completed in 32 children with a mean postburn time of 2.3 +/- 1.5 years and a mean burn size of 44% +/- 23% total body surface area. Exercise variables included expired volume, tidal volume, respiratory rate, tidal/dead space rate, heart rate, and work stage achieved. Temperature monitoring included external auditory canal temperature, burn scar, and normal skin temperature. Values were measured at baseline during and at maximum exercise. Our data indicate all patients reached the same endurance level regardless of the size of the total body surface area burn. Additionally, in a temperature-controlled environment, adequate heat dissipation in children with burns can be maintained during exercise testing without an excessive rise in body temperature.
据推测,由于热损伤后皮肤和附属器遭到广泛破坏,体温调节控制机制会受到损害,这些患者无法耐受长时间工作。前期研究表明,在炎热气候下工作时,大面积烧伤已愈合的患者体温会过度升高。本研究旨在调查烧伤患儿对运动的体温调节反应,并研究运动测试期间的体温变化。对32名儿童进行了心肺应激测试,这些儿童烧伤后的平均时间为2.3±1.5年,平均烧伤面积为体表面积的44%±23%。运动变量包括呼出量、潮气量、呼吸频率、潮气量/死腔率、心率和达到的工作阶段。体温监测包括外耳道温度、烧伤瘢痕和正常皮肤温度。在基线、运动期间和运动最大值时测量数值。我们的数据表明,无论体表面积烧伤的大小如何,所有患者都达到了相同的耐力水平。此外,在温度受控的环境中,烧伤儿童在运动测试期间可以保持足够的散热,而不会出现体温过度升高的情况。