Effect of rewarming and homeostasis of groin-mediated forced-air warming system in patients with hypothermia after cardiopulmonary bypass

Yanmei Liu, Yang‐hui Xu, Jiahai Shi, Jinfeng Wang
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Abstract

Objective To investigate the rewarming effect of groin-mediated forced-air warming system in patients with hypothermia after cardiopulmonary bypass. Methods A total of 100 hypothermia patients after cardiopulmonary bypass were divided into observation group and control group with 50 cases each by random digits table method. Patients in control group received pelma-mediated forced-air warming system, observation group carried out groin-mediated forced-air warming system. The levels of bladder temperature, axillary temperature and lactate concentration were monitored at 10 min (T10), 30 min (T30), 60 min (T60), 90 min (T90) after rewarming in two groups, rewarming time and drainage volume at 90 min after rewarming between two groups was also compared. Results Bladder temperature in observation group were (34.44±0.98), (35.44±1.12), (36.71±1.16), (37.60±1.45) ℃ at T10, T30, T60, T90, axillary temperature were (34.30±1.85), (35.31±1.36), (36.38±1.57), (37.28±1.72) ℃, bladder temperature and axillary temperature in control group were (34.18±1.56), (36.91±1.61), (37.70±1.29), (37.40±1.10) ℃ and (34.45±1.03), (36.30±1.25), (37.70±1.23), (37.19±1.31) ℃, respectively. There was no significant difference in bladder temperature and axillary temperature at T10 and T90 (P>0.05), however, the bladder temperature and axillary temperature was significantly decreased in observation group compared to control group at T30 and T60 (t value was 5.309, 4.073, P 0.05), however, the lactate concentration was significantly decreased in observation group compared to control group at T60 and T90 (t value was 7.276, 8.640, P<0.01), in addition, there were crossover effect of time and grouping factor in lactate concentration (F value was 36.034, P<0.01). Drainage volume at 90 min after rewarming were (95.44±15.24) ml in observation group, (106.08±25.56) ml in control group, the difference was significant between two groups (t value was 2.528, P<0.05). Conclusions Groin-mediated forced-air warming system can effectively and uniformly rewarming the body temperature of patients with hypothermia after cardiopulmonary bypass and served as a potential rewarming strategy. Key words: Cardiopulmonary bypass; Forced-air rewarming; Bladder temperature; Axillary temperature
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腹股沟介导的强制空气加热系统对体外循环后低温患者再温和体内平衡的影响
目的探讨腹股沟介导的强制空气加热系统对体外循环术后低温患者的复温效果。方法将100例体外循环术后低温患者采用随机数字表法分为观察组和对照组各50例。对照组采用盆腔介导的强制空气加热系统,观察组采用腹股沟介导的强制空气加热系统。监测两组患者复温后10 min (T10)、30 min (T30)、60 min (T60)、90 min (T90)膀胱温度、腋窝温度和乳酸浓度,比较两组患者复温后90 min的复温时间和引流量。结果观察组T10、T30、T60、T90时膀胱温度分别为(34.44±0.98)、(35.44±1.12)、(36.71±1.16)、(37.60±1.45)℃,腋窝温度分别为(34.30±1.85)、(35.31±1.36)、(36.38±1.57)、(37.28±1.72)℃,对照组膀胱温度和腋窝温度分别为(34.18±1.56)、(36.91±1.61)、(37.70±1.29)、(37.40±1.10)℃和(34.45±1.03)、(36.30±1.25)、(37.70±1.23)、(37.19±1.31)℃。T10、T90时膀胱温度、腋窝温度差异无统计学意义(P>0.05),但观察组T30、T60时膀胱温度、腋窝温度较对照组显著降低(t值分别为5.309、4.073,P 0.05),观察组T60、T90时乳酸浓度较对照组显著降低(t值分别为7.276、8.640,P<0.01);时间与分组因子对乳酸浓度有交叉影响(F值为36.034,P<0.01)。观察组患者复温后90min引流量为(95.44±15.24)ml,对照组为(106.08±25.56)ml,两组比较差异有统计学意义(t值为2.528,P<0.05)。结论腹股沟介导的空气强制升温系统能有效、均匀地对体外循环后低温患者进行体温复温,是一种有潜力的复温策略。关键词:体外循环;压力复温;膀胱温度;腋窝温度
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