对严重烧伤患者的热调节性血管内导管的评估
Amy Brown1,2, Christopher McGovern1,2, Marie Davidson1,2
1Glasgow Royal Infirmary, Glasgow G4 0SF, UK.
概括
血管内温度控制导管在严重烧伤患者中有效保持正常热量,防止手术延迟. 然而,需要进一步的研究来评估血栓风险,并与当前的做法进行比较.
科学领域:
- 临界护理医学 临界护理医学
- 燃烧管理 燃烧管理
- 热调节 热调节 热调节
背景情况:
- 严重的烧伤带来了温度调节失效的重大风险.
- 对烧伤患者的最佳温度管理策略仍在争论中.
- 血管内温度管理导管显示有前途,但缺乏可靠的数据.
研究的目的:
- 评估在严重受伤的烧伤患者中使用热调节性静脉导管系统 (Thermogard XP®).
- 评估设备在维持正常热量方面的有效性及其对手术程序的影响.
- 识别潜在的并发症,如血栓事件.
主要方法:
- 一个单一的中心,对Thermogard XP®系统的前性评估.
- 包括严重受伤的烧伤患者在18个月内被送往重症监护室.
- 在手术过程中和之后监测患者的体温和温度变化.
主要成果:
- 在10名患者身上插入了12个导管,在ICU中保持温度在36.9°C至38.4°C之间.
- 在手术期间的温度变化对于TBSA≤50%是最小的,但对于TBSA>50%更为显著.
- 没有因为低温而停止手术;72.2%的患者在手术后处于正常热状态. 30%的人经历了血栓性并发症.
结论:
- 热调节导管系统似乎可靠的实现和维持正常热量在重症烧伤患者.
- 该设备可能有利于在手术期间经历温度波动的患者.
- 需要进一步的研究来确认改善的结果,并调查血栓风险.
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