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Effekt av värmemadrass efter ECC-inducerad hypotermi vid hjärtkirurgi: -En kvasiexperimentell pilotstudie
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2013 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Effect of warming mattress after CPB- induced hypothermia in cardiac surgery : - A quasi-experimental pilotstudy (English)
Abstract [sv]

Bakgrund: Vid hjärtkirurgi kyls patienten via ECC (extracorporeal circulation) till 32-34 °C för att minska metabolismen och syrekonsumtionen i vävnaderna. Efter att operationen är klar är det viktigt patienten blir normoterm då hypotermi medför många negativa effekter.

Syfte: Att undersöka om värmemadrassen Inditherm Alpha® hjälper patienten att hålla en normal kroppstemperatur efter ECC-avslut samt om andra faktorer, dels demografiska, dels procedurrelaterade, kan påverka utfallet av uppmätt kroppstemperatur.

Metod: Femtiofem patienter som genomgick elektiv CABG och/eller klaffoperation med ECC-inducerad hypotermi inkluderades konsekutivt. Undersökningsgruppen (n=29) genomgick kirurgi med värmemadrassen Inditherm Alpha® medan jämförelsegruppen (n=26) genomgick kirurgi utan värmemadrass. Grupperna var jämnt fördelade i alla avseenden förutom kön.

Resultat: Flertalet patienter sjönk i kroppstemperatur efter ECC-avslut (p < 0,0001) men majoriteten av patienterna var normoterma vid ankomst till intensivvårdsavdelningen. Undersökningsgruppen hade inte högre kroppstemperatur vid något mättillfälle jämfört med jämförelsegruppen. Faktorer som korrelerade positivt med högre kroppstemperatur var högre BMI samt lång operations- och ECC-tid.

Slutsats: De patienter som tilldelades värmemadrassen Inditherm Alpha® hade inte högre kroppstemperatur vid något tillfälle. Patienter med högre BMI och längre operations- och ECC-tid hade högre kroppstemperatur innan transport till IVA och på IVA.

Abstract [en]

Background: In cardiac surgery patients are cooled via CPB (cardiopulmonary bypass) to 32-34° C in order to decrease the tissues’ metabolism and oxygen consumption. After the operation is completed, it is crucial to obtain normothermia again, since hypothermia has many adverse side effects.

Objective: To investigate whether the warming mattress Inditherm Alpha® helps the patient maintain a normal core temperature after termination of CPB and if other factors, such as demographic or procedural, can affect the core temperature.

Methods: Fifty-five patients undergoing elective CABG and/or valve replacement with CPB-induced hypothermia were consecutively enrolled. The study group (n = 29) underwent surgery with the warming mattress Inditherm Alpha® while the comparison group (n = 26) underwent surgery without the warming mattress. The groups were evenly distributed in all respects but gender.

Results: All patients decreased significantly in core temperature after termination of CPB (p <0.0001), but the majority of patients were normothermic on arrival at the ICU. The study group did not have significantly higher core temperature at any time compared with the control group. Factors that correlated with higher body temperature were higher BMI and longer surgical and CPB-time.

Conclusion: The patients who were assigned the warming mattress Inditherm Alpha® did not have a significant higher core temperature at any time. Patients with higher BMI and longer surgery and CPB- time presented a higher core temperature before transport to the ICU and at the ICU.

Place, publisher, year, edition, pages
2013. , 38 p.
Keyword [en]
cardiac surgery, warming mattress, hypothermia
Keyword [sv]
hjärtkirurgi, värmemadrass, hypotermi
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-202118OAI: oai:DiVA.org:uu-202118DiVA: diva2:630989
External cooperation
Thoraxkirurgi och- Anestesikliniken Akademiska Sjukhuset Uppsala
Subject / course
Caring Sciences
Educational program
Specialistsjuksköterskeprogrammet med inriktning mot anestesisjukvård
Supervisors
Examiners
Available from: 2013-06-20 Created: 2013-06-19 Last updated: 2013-06-20Bibliographically approved

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