Zusammenfassung
Hintergrund
Hypothermia ist ein oft beobachtbares Phänomen bei Traumapatienten während der Akutversorgung. Bekannte Komplikationen einer akzidentellen Hypothermie sind Wundheilungsstörungen, kardiale Komplikationen, hämodynamische Instabilität, Defizite im Immunsystem und vermehrter Blutverlust. In der folgenden Studie verglichen wir passiv gewärmte vs. aktiv gewärmte Patienten auf dem Transport von einer Intensivstation zum CT.
Methoden
Dreißig Intensivpatienten wurden randomisiert zur einer aktiv gewärmten Gruppe, abgedeckt mit einer Carbonfiberwärmedecke (42°C) während des gesamtem Transport und zur einer passiv gewärmten Gruppe, die mit einer ausgeschalteten Carbonfiberdecke versorgt waren. In beiden Gruppen waren die Carbonfiberdecke mit konventionellen Wolldecken abgedeckt. Es wurden die Vitalparameter und die Körpertemperaturen gemessen.
Ergebnisse
Die Ausgangsdaten der Patienten waren in beiden Gruppen vergleichbar. Die Ausgangstemperatur in Gruppe A war 36,4°C±0,2°C und blieb stabil bei 36,4°C±01°C, die Temperatur in Gruppe B startete bei 36,4°C±0,2°C und sank statistisch signifikant auf 34,7°C±0,6°C.
Schlussfolgerungen
Die Hypothermie ist ein gängiges Problem, wenn Patienten wegen der diagnostischen Maßnahme einen innerklinischen Transport benötigen. Das aktive Wärmen dieser Patienten während des Transports kann die Körpertemperatur stabil normotherm halten. We können daher zur Erhaltung der Normothermia das aktive Wärmen von Patienten während eines Transports empfehlen.
Summary
Objective
Hypothermia in trauma victims is a frequently observed phenomenon in acute care. Known complications of hypothermia are impaired wound healing, cardiac complications, hemodynamic instability, impaired immune function and increased blood loss. We compared active warming versus passive warming in hypothermia in critical-care patients undergoing intrahospital transfer from ICU to computer tomography (CT).
Methods
Thirty critically ill patients were randomized either to an actively warmed group, covered with a carbon-fiber heating blanket (set to 42°C) during the entire transport including the time spent in the CT, or to a passively warmed group, covered with a carbon-fiber heating blanket (switched off) during the entire transport and in the CT. The carbon-fiber blanket was covered with a conventional wool blanket in both groups. Vital parameters and core temperatures were recorded.
Results
Patients’ characteristics and vital parameters were similar in each treatment group. Initial average core temperature in group A was 36.4°C±0.2°C and remained stable at 36.4°C±0.1°C; core temperature in group B started at 36.4°C±0.2°C but decreased to 34.7°C±0.6°C.
Conclusions
Hypothermia is common when critically ill trauma patients require intrahospital transport for diagnostic procedures. Resistive heating during intrahospital transport kept the core temperature stable and assured normothermia in all actively warmed patients. We therefore recommend active warming for critically ill trauma patients during intrahospital transport.
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Scheck, T., Kober, A., Bertalanffy, P. et al. Active warming of critically ill trauma patients during intrahospital transfer: A prospective, randomized trial. Wien Klin Wochenschr 116, 94–97 (2004). https://doi.org/10.1007/BF03040703
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DOI: https://doi.org/10.1007/BF03040703