Efikasnost spoljašnjeg zagrevanja u ublažavanju hipotermije kod hirurških bolesnika

  • Snježana Zeba Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
  • Maja Šurbatović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
  • Milan Marjanović Galenika, Belgrade, Serbia
  • Jasna Jevdjić Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Zoran Hajduković Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
  • Radovan Karkalić Military Academy, University of Defence, Belgrade, Serbia
  • Dalibor Jovanović Technical Testing Centre, Belgrade, Serbia
  • Sonja Radaković Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia.
DOI: https://doi.org/10.2298/VSP150330032Z
Ključne reči: anesthesia, general||, ||anestezija, opšta, digestive system surgical procedures||, ||hirurgija digestivnog sistema, procedure, hypothermia||, ||hipotermija, intraoperative period||, ||intraoperativni period, postoperative complications||, ||postoperativne komplikacije, monitoring, physiologic||, ||fiziološke funkcije, praćenje, heating||, ||grejanje,

Sažetak


Uvod/Cilj. Hipotermija kod hirurških bolesnika može biti posledica dugotrajne hirurške intervencije, opšte anestezije i niske temperature vazduha u operacionoj sali. Postoperativna hipotermija može dovesti do brojnih postoperativnih komplikacija kao što su aritmija, ishemija miokarda, hipertenzija, krvarenje, infekcija rane, koagulopatija i produženo dejstvo mišićnih relaksanata. Za prevenciju ovog stanja koristi se spoljašnje zagrevanje. Cilj ove studije bio je procena efikasnosti sistema za spoljašnje zagrevanje radi ublažavanja hipotermije kod bolesnika podvrgnutih dugotrajnim hirurškim procedurama. Metode. Ovo istraživanje sprovedeno je u Vojnomedicinskoj akademiji u Beogradu na 30 bolesnika oba pola koji su nasumice bili podeljeni u dve jednake grupe: u jednoj je primenjeno spoljašnje zagrevanje madracem sa toplim vazduhom, dok je druga bila bez dodatnog zagrevanja (kontrolna grupa). U toku hirurške intervencije, kao i tokom postoperativnog perioda buđenja, promene unutrašnje temperature praćene su preko ezofagusne sonde (Te), a promene temperature kože intraoperativno preko  kontrolnih tačaka na desnoj šaci (Th) i desnom stopalu (Tf). Srčana frekvencija i vrednosti krvnog pritiska praćeni su kontinuirano tokom hirurške intervencije, kao i u toku perioda buđenja. Rezultati. U zagrevanoj grupi, prosečne vednosti Te, Tf i Th nisu se značajno menjale tokom intraoperativnog i postoperativnog perioda. U kontrolnoj grupi, prosečna vrednost Te značajno se smanjila tokom intraoperativnog perioda (sa 35,61 ± 0,35ºC u nultom minutu na 33,86 ± 0,51ºC u 120. minutu). U odnosu na zagrevanu grupu, Te je u kontrolnoj grupi bila značajno niža u svim posmatranim periodima. Prosečne vrednosti Tf i Th značajno su se smanjile u kontrolnoj grupi (sa 30,83 ± 1,85 u 20. minutu na 29,0 ± 1,39ºC u 120. minutu, odnosno sa 32,75 ± 0,96 na 31,05 ± 1,09ºC).
Zaključak. Rezultati ove studije podvrđuju da spoljašnje zagrevanje madracem s toplim vazduhom može da ublaži hipotermiju, odnosno da spreči značajno sniženje unutrašnje temperature do kojeg dolazi tokom izlaganja stresu usled hladnoće tokom hirurške intervencije.

 

 

 

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Objavljeno
2017/03/01
Broj časopisa
Vol. 73 Br. 6 (2016)
Rubrika
Originalni članak