개심술 후 환아에게 적용한 저온담요와 직장용 해열제의 해열효과 비교
Comparison of Antifebrile Effects of Hypothermia Blanket and Rectal Antipyretics for Infants after Open Heart Surgery
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본 연구는 개심술 후 외과계 중환자실에 입실한 환아의 발열 시적용한 저온담요와 직장용 해열제 투여에 따른 해열효과를 비교한 후향적 조사연구이다. 연구대상은 생후 1개월 이상 만 3세 이하의 선천성 심질환을 가진 환아로, 개심술을 받고 외과계 중환자실에 입실한 후 직장체온이 37.2°C 이상으로 상승하여 저온담요를적용하거나 직장용 해열제를 투여한 174명의 환아였다. 저온담요 적용집단이 직장용 해열제 투여집단보다 평균 해열소요시간이 짧았고, 체온도 더 크게 감소하였으며 이는 통계적으로유의하였다. 그리고, 저온담요 적용집단과 직장용 해열제 투여집단 모두에서 6개의 생리적 지표(체온, 심박동수, pH, 동맥혈산소분압, 중탄산이온 및 칼륨이온)가 통계적으로 유의하게 감소하였다. 결론적으로, 저온담요의 적용이 직장용 해열제보다 해열소요시간이 짧으며, 체온을 더 감소시킴을 알 수 있었다. 저온담요는 비침습적이고 비약물적인 해열요법으로써 환아에게 안전하므로 개심술환아의 발열 시 저온담요를 적용하는 것이 바람직하다고 생각한다.
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°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,PaCO2, PaO2, HCO3-, SaO2, 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.
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