Objective
The study aimed to evaluate the changes of body temperature and to identify the factors related to the changes during the operation in burned patients. And, depending upon its results thus acquired, it intends to provide basic data for the development of nursing intervention to prevent hypothermia during surgery according to the characteristics of patients involved.
Methods. A retrospective study design was used. Data were collected at the Burn Center of H university hospital in Seoul from July 1st in 2013 to June 30th in 2014. A total of 439 adult burned patients who had an operation under general anesthesia and with the warming therapy were included in this study. Body temperatures were checked every 30-minutes. General, operational, and burn related characteristics were evaluated. The data were analyzed descriptive statistics, t-test, and ANOVA in SPSS 21.0 Program.
Results
1. Body temperature declined from 36.6℃ to 35.2 ℃ during the surgery; after surgery, 47.8% of patients have a normal body temperature, but 52.2% are hypothermia; 2.3% of hypothermia patients belong to moderate hypothermia.
2. The changes of body temperature were prominent in groups of ‘Room temperature setting + Water circulating blanket + Heated circuit + Hot line’, ‘Room temperature setting + Heated circuit + Hot line’, and ‘Room temperature setting + Hot line’.
3. Changes in body temperature were significantly different by participants’ general characteristics including ASA(F=31.400, p<.001), systolic blood pressure(t=3.998, p<.001), diastolic blood pressure(t=-4.003, p<.001), pulse(F=19.274, p<.001), breathing rate(t=2.496, p<.05), Hb(t=-6.540, p<.001), PT(t=7.394, p<.001), aPTT(F=14.566, p<.001), Na(F=27.298, p<.001), K(t=-2.548, p<.05), RBC(t=-6.507, p<.001), and Neutrophil(t=4.294, p<.001).
4. There were differences in the changes of body temperature according to operation-related characteristics including operation time(F=75.330, p<.001), anesthesia time(F=88.495, p<.001), amount of fluid(F=87.697, p<.001), blood transfusion(t=12.553, p<.001), amount of transfusion(F=50.500, p<.001), and use of tourniquet(t=6.165, p<.001).
5. The changes in body temperature significantly differed by burn-related characteristics including the type of burn(F=13.396, p<.001), extent of burn(F=41.208, p<.001), extent of exposure(F=37.291, p<.001). It is confirmed in the study that factors relevant to the body temperature changes of burn patients during surgery include the warming method, ASA, BP, Pulse, Hb, PT and aPPT, Neutrophil, operation time and anesthesia time, amount of fluid, blood transfusion, blood volume, use or non-use of tourniquet, extent of burn, and extent of exposure during surgery.
Conclusions
Patients with burn experience the decrease of body temperature during their surgery despite of warm therapy. It is needed to provide appropriate warm therapy based on their characteristics to maintain body temperature during their surgery in burned patients. It should be developed a nursing protocol for maintaining body temperature in burned patients.