Maintenance of normothermia during burn surgery with an intravascular temperature control system: A non-randomised controlled trial

详细信息	查看全文 | 推荐本文 |

• 作者：Bertrand Prunet ; ^{bertrand.prunet@orange.fr} ; Yves Asencio ^{yves@asencio.fr} ; Guillaume Lacroix ^{gllacroix@aol.com} ; Julien Bordes ^{bordes.julien@neuf.fr} ; Ambroise Montcriol ^{ambroise.montcriol@free.fr} ; Erwan D&rsquo ; Aranda ^{erwanm3d@gmail.com} ; Jean-Philippe Pradier ^{jean-philippe.pradier@wanadoo.fr} ; Eric Dantzer ^{eric.dantzer@wanadoo.fr} ; Eric Meaudre ^{eric.meaudre@club-internet.fr} ; Philippe Goutorbe ^{goutorbephil@live.fr} ; Eric Kaiser ^{kaiser.eric@free.fr}
• 关键词：Severe burns ; Hypothermia ; Warming catheter ; Normothermia ; Intravascular temperature control ; Burn surgery
• 刊名：Injury
• 出版年：2012
• 期刊代码：120_00201383
• 类别：med
• 出版时间：May, 2012
• 卷：43
• 期：5
• 页码：648-652
• 文件大小：331 K

摘要

Background

Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We evaluated the effectiveness of an intravascular rewarming technique using CoolGard 3000鈩?system and Icy鈩?catheter to maintain normothermia during surgeries of severe burned patients and compared these findings to a historical control group.

Methods

This was a controlled non-randomised trial conducted between March 2008 and August 2009. Patients with burns greater than or equal to 40%of the total body surface area were included. Before the first burn excision, the Icy鈩?catheter was placed in the inferior vena cava via the femoral vein. Warming was then initiated and maintained until the bladder temperature reached over 37.5 掳C. The bladder temperature was recorded every 30 min during surgery and for the first hour post-operatively and compared to a historical control group.

Results

We enrolled 4 patients and 11 surgeries in the CoolGard鈩?group and compared them to 3 patients and 10 surgeries in the historical cohort. All intraoperative bladder temperatures from T = 30 were statistically different in the two groups. In the CoolGard鈩?group, no patient became hypothermic and no surgery was aborted because the patient's temperature had rapidly fallen below the threshold temperature (35.5 掳C). No device-related complication was reported.

Conclusion

The use of an intravenous warming catheter is a novel approach to maintain normothermia during surgery in burn victims and may be more effective than traditional methods.