[Evaluation of a new insulating system for infusion solutions in preclinical trauma therapy: a prospective, randomized study].
OBJECTIVE
Infusion of cold fluids in a patient leads to a reduction of core temperature and subsequently worsens hypothermia. We evaluated the efficacy of a newly developed self-warming insulation device for use in pre-hospital rescue.


METHODS
We studied 50 trauma patients with a rescue time of more than one hour. They were randomly assigned to either infusions taken directly from a warming box in the ambulance (Group A, n = 25) or infusions taken from the warming box and packed in an insulation device (Group B, n = 25). We recorded ambient temperatures, infusion temperatures in five-minute-steps and transport duration of the infusions from the ambulance to the site of accident.


RESULTS
Ambient temperatures and transport duration did not differ significantly between both groups. In Group A the infusion temperature decreased from 36.0 +/- 6.4 degrees C to 19.8 +/- 6.8 degrees C during the transport from the ambulance to the site of accident. In Group B infusion temperature decreased only about 1 degree C. In Group A the temperature of the infusion continued to decrease until the end of measurements. In contrast in Group B the infusion temperature even increased by 0.5 degree C over the measurement period. These differences between the two groups were statistically significant.


CONCLUSIONS
Our data show that even pre-warmed infusions from a warming box cool down considerably before they can be given to the patient. A self-warming insulation device can stabilize infusion temperature even under extreme conditions of prehospital trauma care.
Scheck
Thomas
T
Universitätsklinik für Anästhesie und Allgemeine Intensivmedizin, Wiener Rotes Kreuz, Bezirksstelle Van Swieten, Forschungsinstitut des Wiener Roten Kreuzes, Wien, Osterreich.
Kober
Alexander
A
Heigl
Peter
P
Schiller
Edeltraud
E
Buda
Peter
P
Szvitan
Gabor
G
Lieba
Frank
F
Hoerauf
Klaus
K
D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D004632:Emergency Medical Services / Q000379:methods*; D004867:Equipment Design; D005121:Extremities / Q000293:injuries; D005260:Female; D005440:Fluid Therapy / Q000295:instrumentation*; D006361:Heating; D006801:Humans; D007035:Hypothermia / Q000517:prevention & control*; D007262:Infusions, Intravenous / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000295:instrumentation*; D013696:Temperature; D014947:Wounds and Injuries / Q000503:physiopathology / Q000628:therapy*