Platt A J, Aslam S, Judkins K, Phipps A R, Smith G L
Yorkshire-Burn Centre, Pinderfields General Hospital, Wakefield, UK.
Burns. 1997 May;23(3):250-5. doi: 10.1016/s0305-4179(96)00103-9.
Temperature and resuscitation profiles of 15 non-survivors were compared with matched survivors of major burns. All patients were intubated and ventilated for smoke inhalation injury, survived more than 3 days postburn and had a cutaneous burn greater than 15 per cent of the body surface area (mean 32.3 +/- 11.0 per cent SD). Cases were matched for similar ages (within 10 years) and total body surface area burn (within 10 per cent). The rate of core temperature rise following admission to the burn unit was significantly greater in survivors (mean 0.46 +/0 0.18 degree C/h) compared with matched non-survivors (mean 0.30 +/- 0.15 degrees C/h; p < 0.01). Core temperature increased at a rate of 0.27 degrees C/h or greater in all survivors, whereas 7 non-survivors raised their core temperature at a rate less than this. The rate of skin temperature rise was also significantly greater in the survivors (mean 1.35 +/- 0.91 degrees C/h) compared with matched non-survivors (mean 0.63 +/- 0.43 degrees C/h, p < 0.01). In 13/15 survivors, the skin temperature increased at a rate of 0.6 degree C/h or greater, whereas in 8/15 non-survivors skin temperature increased at a rate less than this. There was a negative relationship between initial core temperature and delay from time of burn to admission to the burns unit in non-survivors (correlation coefficient = -0.92; p < 0.01), whereas there was no effect of delay in the survivors. These findings suggest that patients with a high mortality probability can be detected early in their clinical course by means of temperature profiles.
将15名非幸存者的体温和复苏情况与相匹配的重度烧伤幸存者进行了比较。所有患者均因吸入性损伤而行气管插管和机械通气，烧伤后存活超过3天，皮肤烧伤面积大于体表面积的15%（平均32.3±11.0%标准差）。病例按年龄相近（相差10岁以内）和烧伤总面积相近（相差10%以内）进行匹配。与相匹配的非幸存者相比，烧伤病房收治后幸存者的核心体温上升速率显著更快（平均0.46±0.18℃/小时）（相匹配的非幸存者平均为0.30±0.15℃/小时；p<0.01）。所有幸存者的核心体温以0.27℃/小时或更快的速率上升，而7名非幸存者的核心体温上升速率低于此值。与相匹配的非幸存者相比，幸存者的皮肤温度上升速率也显著更快（平均1.35±0.91℃/小时）（相匹配的非幸存者平均为0.63±0.43℃/小时，p<0.01）。15名幸存者中有13名的皮肤温度以0.6℃/小时或更快的速率上升，而15名非幸存者中有8名的皮肤温度上升速率低于此值。在非幸存者中，初始核心体温与从烧伤到进入烧伤病房的延迟时间呈负相关（相关系数=-0.92；p<0.01），而在幸存者中延迟时间没有影响。这些发现表明，通过体温曲线可以在临床过程早期检测出具有高死亡概率的患者。
