Hypothermia
Conditions
Interventions
Rewarming of hypothermic septic patients with a thermal airflow blanket maintained at 40 or 45ºC throughout the procedure or 47ºC in the first 15 minutes with automatic reduction to 45ºC until the end
Sponsors
Programa de Pós-Graduação em Ciências Cardiovasculares - Universidade Federal Fluminense
Programa de Pós-Graduação em Ciências Cardiovasculares - Universidade Federal Fluminense
Eligibility
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Patients over 18 years old; admitted to the Intensive Care Unit; diagnosed with sepsis according to the criteria known as Sepsis 3; with a suspected or documented infection; with a sharp increase 2 in the SOFA index.
Exclusion criteria
Exclusion criteria: Extensive burns (greater than 30% of the body surface); metastatic cancer; cerebral tumor; head trauma; spinal cord injury; pregnancy; use of active cooling less than 24 hours of sepsis diagnosis; surgery less than 24 hours after the first occurrence of hypothermia. For thermography analyzes, patients who do not tolerate exposure to room temperature (temperature of 23 more or less 1ºC for 15 minutes) required for thermalization. For the analysis of the impact of different types of baths on the bed, the following will also be excluded: Individuals with continuous infusion of regular insulin at the time of bed bath, due to reduced glycemia caused by the medication; Patients on hemodialysis (HD) when bathing in bed, due to the reduction in blood glucose caused by the procedure; Patients diagnosed with tumors that affect insulin production, due to the inability to define whether the cause of eventual glycemic changes is the bed bath or the activity of the tumor; Patients who resent hypoglycemia (blood glucose lower than 70mg / dl) in the pre-bath moment, in addition to to control a possible confounder, avoid the occurrence of severe hypoglycemia (less than 40 mg / dL); Patients in palliative care for any pathology, because the therapeutic proposal for palliation is not consistent with curative actions.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To evaluate changes in oxyhemodynamic caused by active rewarming with a thermal airflow blanket and bed bath with wet wipes, using method of analysis of multiparameter monitor, mesuared by changes in blood pressure, heart rate, respiratory frequency, pulse oximetry;To evaluate changes is glycemia of septic patients admitted to the ICU caused by active rewarming with a thermal airflow blanket and a bed bath with wet wipes, using method of analysis of hemoglucotest, measured by alterations in glycemia;To evaluate changes in biochemical parameters of septic patients admitted to the ICU caused by active rewarming with a thermal airflow blanket and a bed bath with wet wipes using method of analysis of laboratory tests, measured by alterations in sodium, potassium, BNP and troponin;To evaluate thermographic changes of septic patients admitted to the ICU caused by active rewarming with a thermal airflow blanket and a bed bath with wet wipes using method of analysis of thermographic images by a portable camera, measured by alterations in body ditribuition of temperature;To evaluate echocardiographic changes of septic patients admitted to the ICU caused by active rewarming with a thermal airflow blanket and a bed bath with wet wipes using method of analysis of echocardiography measured by alterations in diastolic function | — |
Secondary
| Measure | Time frame |
|---|---|
| Occurence of arrhythmias, using method of analysis of eletrocardiogram, measured by alterations of heart rate or cardiac rhythm;Occurence of tremors, using method of analysis based on visual confirmation, measures by tremors scale;Occurence of hypoglycemia, using method of analysis of hemoglucotest, measured by decrease of glycemia to 70 mg/dL or less;Occurrence of recurrent hypothermia, using method of analysis of esophageal thermometer, measured by decrease of temperature to less than 36º;Occurrence of delirium, using method of analysis of CAM-ICU scale, measured by presence of characteristics 1 and 2 and presence of characteristicas 3 or 4 described on scale;Analysys of length of stay in the ICU, using method of analysis of registry of days in ICU, measured by comparison between patients with and withou hypothermia;Evaluation of changes in the thermal pattern of the septic patient, using method of analysis of esophageal thermometer, measured by alterations of body temperature;Mesurement of reheating time until normothermia using method of analysis of timing by using a stopwatch, measured in minutes;Evaluation of reheat rate using method of analysis of timing and esophageal thermometer, measured by alterations of heart rate or cardiac rhythm measured in ºC / min;Measurement of mechanical ventilation time using method of analysis of registry of days in mechanical ventilation, measured by comparison between patients with and withou hypothermia;Evaluation of workload of the nursing team during the bed bath using method of analysis of timing by using a stopwatch, measured in minutes | — |
Countries
Brazil
Contacts
Public ContactDalmo Machado
Programa de Pós-Graduação em Ciências Cardiovasculares - Universidade Federal Fluminense
Outcome results
None listed