Effekten af eksperimentel hypotermi ved kold luft
Accidental hypothermia er forbundet med høj morbiditet og mortalitet, og der er behov for bedre behandlingsstrategier. Denne undersøgelse præsenterer en ny metode til kliniske forsøg vedrørende eksperimentel hypotermi, der muliggør studier af aktiv opvarmning ved brug af kold luft, hvilket kan efterligne ofte forekommende kliniske scenarier for hypoterme patienter [source_link].
I en randomiseret, dobbeltblind crossover-studie deltog 15 raske frivillige iført våde klæder, som blev udsat for en blæsende klimakammer sat til 5 °C. Hver deltager gennemførte det eksperimentelle forløb to gange, én gang med aktive lægemidler (meperidin og buspiron) og én gang med placebo. Der var en uges vaskerperiode mellem forsøgene.
Det primære endpoint var kropstemperatur ved forsøgets afslutning, defineret som 3 timers eksponering eller 35 °C. Forskellene mellem grupperne blev vurderet ved hjælp af analyse af kovarians (ANCOVA) med venstre censurering (Tobit-model) og individuel random intercept. Sekundære endepunkter omfattede forløbet af kropstemperatur og reduktion af rystelser.
Resultaterne viste, at der ved afslutningen var en temperaturforskel på 1,4 °C mellem aktiv behandling og placebo. Justeret for deltagere, der nåede 35 °C, var den estimerede gennemsnitlige forskel 1,7 °C (1,4-2,0, p < 0,001). Rystelser blev effektivt reduceret, men ikke helt inhiberet af lægemiddelregimen, og kropstemperaturen faldt med en hastighed på -0,82 °C pr. time.
Dette er en AI-genereret oversættelse og opsummering. Læseren bør konsultere den originale kilde for validering og ikke træffe kliniske beslutninger udelukkende på baggrund af dette resumé.
#Akutmedicin #Anæstesiologi #Intern medicin: gastroenterologi
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Scand J Trauma Resusc Emerg Med. 2025 Jan 31;33(1):16. doi: 10.1186/s13049-025-01331-4.
- PMID: 39891247
- PMCID: PMC11786356
- DOI: 10.1186/s13049-025-01331-4
Abstract
Background: Accidental hypothermia is associated with high morbidity and mortality. Research on treatment strategies for accidental hypothermia is complicated by the low incidence and heterogeneous patient population. We have developed a new method for clinical trials of experimental hypothermia, to enable further studies of active rewarming. If cold ambient air is effective as a cooling method, this would mimic the most frequent clinical setting of hypothermic patients and provide a feasible cooling method for field studies. We aimed to induce mild hypothermia in healthy volunteers by exposure to cold ambient air, and tested the hypothesis that drug-induced suppression of endogenous thermoregulation would be required.
Methods: In a randomized, double-blind, crossover design, 15 healthy volunteers wearing wet clothes were put in a windy climate chamber set to 5 °C. Each participant completed the experimental procedure twice, once receiving active drugs (meperidine and buspirone) and once receiving placebo. The experiments were separated by a one-week wash-out period. Primary outcome was core temperature at termination, defined as 3 h of exposure or 35 °C. The between-groups difference was assessed using analysis of covariance (ANCOVA) with left censoring (Tobit model) and individual random intercept. Secondary outcomes were trajectory of core temperature and reduction of shivering.
Results: At termination, the active drug vs placebo group differed in temperature by 1.4 °C. With adjustment for the removal of participants reaching 35 °C, the estimated mean difference was 1.7 °C (1.4-2.0, p < 0.001). Shivering was effectively reduced, but not completely inhibited by the drug regimen, and core temperature declined at a rate of – 0.82 °C per hour.
Conclusion: The novel protocol utilizing cold air as a cooling method and drug-induced suppression of endogenous thermoregulation, is effective and enables future research projects. We have provided suggestions for minor alterations.
Trial registration: EudraCT ID 2023-506020-81-00.
Keywords: Accidental hypothermia; Emergency medicine; Mountain medicine; Prehospital; Protocol; Shivering; Thermoregulation.
© 2025. The Author(s).
Publication types
- Randomized Controlled Trial
MeSH terms
- Adult
- Body Temperature Regulation / drug effects
- Body Temperature Regulation / physiology
- Buspirone
- Cold Temperature*
- Cross-Over Studies*
- Double-Blind Method
- Female
- Healthy Volunteers
- Humans
- Hypothermia / prevention & control
- Hypothermia, Induced / methods
- Male
- Young Adult
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