Optimal Heating Temperature in Major Burns Patients

Not Applicable

• Conditions: Thermal Injury; Nurse's Role; Burns
• Interventions: Device: Active external overheating with heating plate, Aragonia ® MTC 400; Device: Active external overheating with air blanket, Equator Level 1® de Smiths Medical

• Registration Number: NCT04396951
• Lead Sponsor: University Rovira i Virgili

Brief Summary

pre and post intervention quasi-experimental epidemiological study without a control group will be carried out in large burned patients that will evaluate the influence on metabolic expenditure of the inclusion of active external rewarming in the control of body temperature.

Detailed Description

the heavily burned patient requires specific care to prevent hypothermia and maintain body temperature. You are at high risk of developing hypothermia in the acute phase due to heat losses from convection, radiation, evaporation, and conduction. After the acute phase, the patient due to physiological mechanisms and the hypermetabolic response mainly demands a temperature close to 38.5ºC, ruling out the infectious focus. According to the authors, environmental temperatures between 28-33ºC are recommended for the care of these patients to decrease energy expenditure. The research carried out has studied the influence of passive external heating (environmental regulation), without including the influence of active external heating (heat blankets, heating plate ...) or the study of the thermal comfort of large burned patients and of professionals who provide them they attend.

A pre and post intervention quasi-experimental epidemiological study without a control group will be carried out in large burned patients that will evaluate the influence on metabolic expenditure of the inclusion of active external rewarming in the control of body temperature. Metabolic expenditure will be measured by indirect calorimetry in the usual treatment with passive external rewarming and post-intervention in the combination of passive and active external heating. The combination of passive and active external reheating will previously study the operating temperature in various cases for optimal application, as well as the definition of thermal comfort in the large burn unit. The specific training of the personnel involved in the care of these patients will be required for the application of the evidence-based recommendations and the evaluation of their implementation.

Study Timeline

• Status Verified: 2020-05
• Study First Submitted: 2020-05-06
• Study First Submitted QC: 2020-05-15
• Last Update Submitted: 2020-05-15
• Study First Posted: 2020-05-21
• Last Update Posted: 2020-05-21
• Study Start: 2020-09-01
• Primary Completion: 2022-03-01
• Study Completion: 2022-10-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 34

Inclusion Criteria

• Patients over 18 years of age.
• Patients with thermal burns.
• Patient with high burn criteria according to ABA:
• 2nd degree burn
• Patient 18 - 59 years: SCQ> 20%
• Patient> 60 years or pathology: SCQ> 10%
• 3rd degree burn
• SCQ> 10%
• Patients on mechanical ventilation

Exclusion Criteria

• Sepsis criteria according to ABA.
• Enzyme debridement application (data within 24 hours).
• 6 hours after a surgical intervention.
• After 2 hours after healing burns
• Patients in hemorrhagic shock

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Active external overheating with heating plate	Active external overheating with heating plate, Aragonia ® MTC 400	Combination of passive and active external heating with heating plate Measure during 6 hours with indirect calorimetry
Active external overheating with air blanket	Active external overheating with air blanket, Equator Level 1® de Smiths Medical	Combination of passive and active external heating with convective air blanket Measure during 6 hours with indirect calorimetry

Primary Outcome Measures

Name	Time	Method
Metabolic expenditure	Measure during 6 hours with indirect calorimetry in first recovery week with three heating methods	Compare the metabolic expenditure of burned patients according to the heating method between the combination of active and passive external adjusted to thermal comfort versus external passive overheating.

Secondary Outcome Measures

Name	Time	Method
Optimal environmental temperature	Measure during 6 hours with three heating methods in first recovery week	Define the optimal environmental temperature according to the characteristics of the patient with a large burn during the acute phase, assigning the available resources.
Thermal comfort	Measure during 6 hours with three heating methods first recovery week	Analyze thermal comfort according to heating methods in large burned patients.