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Comparison of Antifebrile Effects of Hypothermia Blanket and Rectal Antipyretics for Infants after Open Heart Surgery

개심술 후 환아에게 적용한 저온담요와 직장용 해열제의 해열효과 비교

  • Received : 2012.05.07
  • Accepted : 2012.10.20
  • Published : 2012.12.31

Abstract

Purpose: The purpose of this study was to compare the effectiveness for infants of antifebrile therapy using a hypothermia blanket or rectal antipyretics following open heart surgery. Methods: This was a retrospective study and 174 infants who had open heart surgery at P University Hospital, and whose body temperature body temperature exceeded $37.2^{\circ}C$ were included in the study. The assessment tool was composed of 32 items was used for assessment of fever therapy, physiological indexes and antifebrile duration. Physiological indexes included systolic blood pressure, diastolic blood pressure, heart rate, pH, $PaCO_2$, $PaO_2$, $HCO_3{^-}$, $SaO_2$, and $K^+$ and the antifebrile duration was minutes from having a fever until BT returned to normal levels. Results: The antifebrile duration with the hypothermia blanket was shorter than with rectal antipyretics. There were significant differences in the physiological indexes with either type of antifebrile therapy, but drop in BT was greater with the hypothermia blanket than rectal antipyretics. Conclusion: The results of this study indicate that a hypothermia blanket is a non-invasive, non-drug and safe antifebrile therapy. Therefore, a hypothermia blanket can be applied to infants with a fever following open heart surgery.

Keywords

References

  1. Bahn, Y. J., Shin, H. W., Lee, H. W., Lim, H. J., Yoon, S. M., & Jang, S. H. (2006). Hypothermia induced by incorrect monitoring of core temperature: A case report. Korean Journal of Anesthesiology, 50, 217-220. https://doi.org/10.4097/kjae.2006.50.2.217
  2. Chung, Y. S., & Kim, J. S. (2009). Pediatric nurses' knowledge and attitudes toward childhood fever. Journal of Korean Academy of Child Health Nursing, 15, 171-181. https://doi.org/10.4094/jkachn.2009.15.2.171
  3. Dennis, C. G., David, C., Arthur, S., David, W. H., Steven, E. W., & David, N. H. (2003). Influence of fever on the hypermetabolic response in burninjured children. Archives of Surgery, 138, 169-174. https://doi.org/10.1001/archsurg.138.2.169
  4. Edwards, H. E., Courtney, M., Wilson, J., Monaghan, S., & Walsh, A. M. (2003). Fever management audit: Australian nurses' antipyretic usage. Pediatric Nursing, 29(1), 31-37.
  5. Jeong, Y. S., & Kim, J. S. (2010). Fever and fever management in children: A literature review. Journal of Korean Academy of Child Health Nursing, 16(1), 30-40. https://doi.org/10.4094/jkachn.2010.16.1.30
  6. Judith, O., Peter, A., Carley, F., & Bennett, L. (1997). Use and effectiveness of hypothermia blankets for febrile patients in the intensive care unit. Clinical Infectious Diseases, 24, 1208-1213. https://doi.org/10.1086/513660
  7. Jung, J. W. (2011). Rare occurrence of congenital heart disease and diseases survey. Chungbuk: Korea Centers for Disease Control and Prevention.
  8. Kang, H. S., & Yun, O. B. (2010). A study on the guardian's experience about tepid massage of children who were admitted to a pediatric emergency room. Horizon of Nursing, 7(1), 65-74.
  9. Kim, W. G., Lee, H. W., & Lim, C. (1997). End point temperature of rewarming and afterdrop after hypothermic cardiopulmonary bypass in pediatric patients. The Korean Journal of Thoracic and Cardiovascular Surgery, 30, 125-130.
  10. Kramer, M. S., Naimark, L. E., Renee, R. B., McDougall, A., & Leduc, D. G. (1991). Risks and benefits of paracetamol antipyresis in young children with fever of presumed viral origin. Lancet, 337, 591-594. https://doi.org/10.1016/0140-6736(91)91648-E
  11. Lee, D. S., Chee, H. K., Shin, Y. C., & Kim, E. J. (2004). Treatment of systemic inflammatory response syndrome (SIRS) following open heart surgery developed into shock: A case report. The Korean Journal of Thoracic and Cardiovascular Surgery, 37, 922-924.
  12. Lee, S. H., Yoo, T. H., Kim, K. G., & Kim, B. H. (2002). Exertional heat stroke: Clinical characteristics and courses of 15 patients. The Korean Journal of Medicine, 62, 379-389.
  13. Lee, T. J., & Kim, D. S. (2007). Fever. Korean Journal of Pediatrics, 50(2), 121-126 https://doi.org/10.3345/kjp.2007.50.2.121
  14. Marilyn, J. H., & David, W. (2008). Wong's essentials of pediatric nursing (8th ed.). Canada: Mosby.
  15. Park, H. S., & Yoon, H. S. (2007). A comparison of the effects of intravenous fluid warming and skin surface warming on peri-operative body temperature and acid base balance of elderly patients with abdominal surgery. Journal of Korean Academy of Nursing, 37, 1061-1072. https://doi.org/10.4040/jkan.2007.37.7.1061
  16. Park, K. H., Jun, T. G., Chee, H. K., Lee, J. R., Kim, Y. J., Rho, J. R., et al. (1996). Evaluation of neurologic abnormalities after deep hypothermic circulatory arrest for pediatric cardiac surgery. The Korean Journal of Thoracic and Cardiovascular Surgery, 29, 14-23.
  17. Park, S. H., Lee, K. N., Moon, J. I., & Lee, J. H. (1990). Changes in arterial oxygen saturation, pulse, and temperature in patients during recovery period according to operative sites and anesthetic methods. Korean Journal of Anesthesiology, 23, 1973-1978.
  18. Russell, F. M., Shann, F., Curtis, N., & Mulholland, K. (2003). Evidence on the use of paracetamol in febrile children. Bulletin of the World Health Organization, 81, 367-372.
  19. Seo, T. B. (2011). See table for 2010 operation status of cardiovascular disease in Korea. Seoul: The Korea heart Foundation.
  20. Thomas, D. O. (1995). Fever in children: Friend or foe. RN, 58(4), 42-48.
  21. Walsh, A. M., Edwards, H. E., & Fraser, J. (2007). Influences on parents' fever treatment: Beliefs, experiences and information sources. Journal of Clinical Nursing, 16, 2331-2340. https://doi.org/10.1111/j.1365-2702.2006.01890.x
  22. Yoo, H. Y. (2002). Mosby's medical, nursing & allied health dictionary (6th ed.). Seoul: Hyunmoon Publisher.