Evaluation of a thermoregulatory intravascular catheter in critically ill burns patients

Abstract

Patients with severe burns are at high risk of thermoregulatory failure. Yet, there is a lack of consensus regarding the optimum approach to temperature dysregulation in patients with severe burns. Intravascular temperature management catheters may offer a superior method of temperature control, but robust data are lacking. In this article, we describe our experience in using a thermoregulatory catheter for temperature management in a tertiary referral burns center. We conducted a single-center, prospective evaluation of the use of a thermoregulatory intravenous catheter system (Thermogard XP®) in critically injured burns patients admitted to our intensive care unit over an 18-month period. Ten patients had a total of 12 catheters inserted. Patient temperatures were maintained between a median low of 36.9 °C and a median high of 38.4 °C while in the intensive care unit. If patients were transferred to theater, the median temperature change was -0.15 °C (interquartile range [IQR] -0.3, 0) if TBSA was ≤50% and -1.45 °C (IQR -2.05, -0.975) if >50%. No surgical procedures were terminated due to intraoperative hypothermia. On return from theater, 72.2% of patients were normothermic with a median temperature of 36.8 °C. Thirty percent of patients developed a thrombotic complication. Overall, the device appeared reliable in achieving and maintaining normothermia for critically ill burns patients manifesting temperature dysregulation. It may also be of benefit to patients expected to show temperature fluctuations during operative procedures. Further research is needed to define whether this represents an improvement over current practice and investigate the thrombus risk associated with such devices.

Keywords: burn surgery; intensive care; intravascular temperature control; intravascular temperature management catheter; severe burns.