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Objective:Sepsis patients usually have a fever, but it is still controversial about whether sepsis patients with fever need cooling treatment. This study aimed to evaluate the effect of external physical cooling on the prognosis of sepsis patients.Methods:This study was a single-center, open-label, randomized clinical trial. Adult sepsis patients with body temperature above 38.3 °C admitted to the Critical Care Medicine of Northern Jiangsu People's Hospital from June 2020 to December 2020 were selected, and randomly assigned in a 1∶1 ratio to the cooling group and control group. Patients in the cooling group used external physical cooling methods to reduce their core body temperature to the normal range (36.5-37.5°C) within 4 h of enrollment and maintained for 48 h. Standard care was implemented in the control group at all times, and all antipyretic treatments were prohibited. The 28-day mortality, 72 h-Δ sequential organ failure assessment (SOFA) score (SOFA score at enrollment–SOFA score after 72 h), length of hospital stay and length of ICU stay were compared between the two groups.Results:A total of 53 patients (32 males and 21 females) were enrolled in the study, including 26 patients in the cooling group and 27 patients in the control group. There were no statistical differences in age, sex, source of infection, SOFA score and body temperature between the two groups (all P>0.05). There was no significant difference in the 28-day mortality between the cooling group and the control group ( RR=1.38, 95% CI: 0.62-3.07, P=0.430). The 72 h-ΔSOFA score of the cooling group was significantly higher than that of the control group, the mean difference between the two groups was 1.90 (95% CI: 0.09-3.71, P=0.040), and there was no significant difference in length of hospital stay, length of ICU stay and 28-day mortality between the two groups. Conclusions:External physical cooling management can not significantly reduce the 28-day mortality of sepsis patients. However, external physical cooling can reduce the 72-h SOFA score in sepsis patients, and improve the organ function of patients.
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Objective To explore the clinical application of combined cooling of Chinese and Western medicine on the cooling effect of patients with heatstroke. Methods A total of 80 patients with severe heat stroke admitted to the emergency department of our hospital from January 2016 to December 2017 were selected and divided into treatment group and control group according to the random number table method. 40 patients in the control group were given physical cooling. For conventional treatment, patients in the treatment group were given TCM treatment interventions on the basis of this, and clinical efficacy, changes in body temperature, and adverse screening events were compared between the two groups. Results The clinical effective rate (100.00%, ) in the treatment group was significantly higher than that in the control group (85.00%, Z=6.125,P<0.05). The duration of high fever, duration of fever, and recovery time of symptoms and signs were (0.57±0.46), (3.12±0.75), (7.25±3.18) h in the treatment group, (1.43±0.89), (5.37±0.63), (12.47± 4.53) h in the control group, there were significant differences between the two groups (t=5.429, 14.528, 5.965, P<0.05). After treatment, the levels of cTnl and CK-MB in the peripheral blood of the two groups decreased significantly (P<0.05). The levels of cTnl and CK-MB in peripheral blood of patients in the treatment group were (3.13±0.15) μg/L, (412.02±156.33) U/L, (3.54± 0.26) μg/L, (748.32±119.20) U/L in the control group, there were significant differences between the two groups (t=8.639, 10.819,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (χ2=2.222, P=0.263). Conclusion The combination of Chinese and Western medicine physical cooling has a significant cooling effect on patients with heat stroke, and does not increase the risk of adverse reactions, it is worth clinical Promotion and application.
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Objective To explore the effects and indications of physical cooling in fever patients after bone fracture surgery.Methods 450 fever patients after bone fracture surgery were selected.They were divided into different groups according to ~e main influencing factors which affected the effect of physical cooling,including the temperature of sponge bathing,the degree of fever,clinical phases of fever.The influence of above factors on physical cooling was observed.Results The temperature for sponge bathing maintaining at 38～40 ℃(the experimental group) achieved better results than that at 32～34 ℃(the control group).Physical cooling at constant peak period of fever had better effect than that during the fervescence period,and the effect of sponge bathing treatment was better in mild fever patients than in high fever patients.Conclusions The single physical hypothermia only fit the patients following bone fracture surgery who had a fever below 38.5 ℃.Patients who had an infectious high fever should receive drug combination.Temperature of sponge bathing maintaining at 38～40 ℃,bathing timing at constant peak period of fever may get best cooling effect.
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0.05, while the differences between 2 groups in cooling effects on the points of cooling 2.5 hours and 4.0 hours were significant, F