Effect of a vapor barrier in combination with active external rewarming for cold-stressed patients in a prehospital setting: a randomized, crossover field study.

Autor: Mydske S; Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway. sigurd.mydske@norskluftambulanse.no.; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway. sigurd.mydske@norskluftambulanse.no.; Department of Clinical Medicine, University of Bergen, Bergen, Norway. sigurd.mydske@norskluftambulanse.no., Brattebø G; Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway.; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Norwegian National Advisory Unit on Emergency Medical Communication, Haukeland University Hospital, Bergen, Norway., Østerås Ø; Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway.; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway., Wiggen Ø; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway.; SINTEF Technology and Society, Preventive Health Research, Trondheim, Norway., Assmus J; Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway.; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Thomassen Ø; Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway.; Mountain Medicine Research Group, The Norwegian Air Ambulance Foundation, Bergen, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2024 Apr 25; Vol. 32 (1), pp. 35. Date of Electronic Publication: 2024 Apr 25.
DOI: 10.1186/s13049-024-01204-2
Abstrakt: Background: Use of a vapor barrier in the prehospital care of cold-stressed or hypothermic patients aims to reduce evaporative heat loss and accelerate rewarming. The application of a vapor barrier is recommended in various guidelines, along with both insulating and wind/waterproof layers and an active external rewarming device; however, evidence of its effect is limited. This study aimed to investigate the effect of using a vapor barrier as the inner layer in the recommended "burrito" model for wrapping hypothermic patients in the field.
Methods: In this, randomized, crossover field study, 16 healthy volunteers wearing wet clothing were subjected to a 30-minute cooling period in a snow chamber before being wrapped in a model including an active heating source either with (intervention) or without (control) a vapor barrier. The mean skin temperature, core temperature, and humidity in the model were measured, and the shivering intensity and thermal comfort were assessed using a subjective questionnaire. The mean skin temperature was the primary outcome, whereas humidity and thermal comfort were the secondary outcomes. Primary outcome data were analyzed using analysis of covariance (ANCOVA).
Results: We found a higher mean skin temperature in the intervention group than in the control group after approximately 25 min (p < 0.05), and this difference persisted for the rest of the 60-minute study period. The largest difference in mean skin temperature was 0.93 °C after 60 min. Humidity levels outside the vapor barrier were significantly higher in the control group than in the intervention group after 5 min. There were no significant differences in subjective comfort. However, there was a consistent trend toward increased comfort in the intervention group compared with the control group.
Conclusions: The use of a vapor barrier as the innermost layer in combination with an active external heat source leads to higher mean skin rewarming rates in patients wearing wet clothing who are at risk of accidental hypothermia.
Trial Registration: ClinicalTrials.gov identifier: NCT05779722.
(© 2024. The Author(s).)
Databáze: MEDLINE
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