Critical illness : CHFによる体温低下

概要

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We investigated the degree of heat loss from the circuit of continuous hemofiltration (CHF) and the influence of CHF on core temperature in critically ill patients with acute renal failure. The core temperature, and extracorporeal blood temperature at the entrance and exit of the CHF filter of five patients were measured at 1-h intervals during 22.8+_-14.1 h. The difference in the blood temperature between the entrance and exit of the filter (ΔT) was 3.6+_-0.7℃ with a 86.0+_-5.5 ml/min CHF blood flow rate (Qb) ancl 600 ml/h ultrafiltration rate (Qf). No patient showed a significant decrease of core temperature after the induction of CHF. The heat loss from the CHF circuit (ΔQ) was 421 kcal/day according to the formula ; ΔQ(cal/min)=ρ(blood density) ×χ(blood specific heat) × Qb × ΔT, ρ=1.05 and χ=0.87, in healthy adults. CHF causes heat loss from the circuit. Additionally, it may not only require higher energy expenditure to keep the core temperature but can result in hypothermia in critically ill patients. Above all, these results show the danger for the underestimation of SIRS in patients during CHF if hypothermia occurs.
日本アフェレシス学会の論文
1999-02-28