Clack JE, Walker SB, Dwyer TA, et al.
Australian critical care : official journal of the Confederation of Australian Critical Care Nu.... Date of publication 2021 Jun 21;volume ():.
1. Aust Crit Care. 2021 Jun 21. pii: S1036-7314(21)00071-0. doi:
10.1016/j.aucc.2021.05.005. [Epub ahead of print]
Factors contributing to the restoration of normothermia after hypothermia in
people with a major burn injury in the first 24 h of hospital admission.
Clack JE(1), Walker SB(2), Dwyer TA(3).
Author information:
(1)School of Nursing Midwifery and Social Sciences, Central Queensland
University, Bruce Highway, Rockhampton 4702, Queensland, Australia. Electronic
address: jclack@swin.edu.au.
(2)School of Nursing Midwifery and Social Sciences, Central Queensland
University, Bruce Highway, Rockhampton 4702, Queensland, Australia. Electronic
address: s.walker@cqu.edu.au.
(3)School of Nursing Midwifery and Social Sciences, Central Queensland
University, Bruce Highway, Rockhampton 4702, Queensland, Australia. Electronic
address: t.dwyer@cqu.edu.au.
BACKGROUND: People with burn injury experiencing hypothermia are at risk of
serious complications such as shock, multisystem organ failure, and death. There
is limited information available for health professionals with regard to factors
that contribute to restoration of normothermia after hypothermia in people with a
major burn injury.
OBJECTIVE: The aim of the study was to identify factors that contribute to
normothermia restoration after hypothermia in people with 10% or more total body
surface area (TBSA) burn in the first 24 h of admission to a burn care hospital.
METHODS: The study was guided by the Gearing Framework for retrospective chart
audit. The sample comprised medical charts of all adult people (n = 113) with a
burn injury more than 10% of their TBSA admitted to a single-site burn care
hospital intensive care unit in Victoria, Australia, between May 31, 2013, and
June 1, 2015. Descriptive statistics were used to describe the sample, and
logistic regression was conducted to predict variables contributing to return to
normothermia in people with burn injury. Charts with incomplete data were
excluded.
FINDINGS: The sample (n = 50) recorded a median initial temperature on admission
to the emergency department (ED) of 35.4°C (range = 31.9-37.2°C) and took on an
average of 6.2 (standard deviation [SD] = 4.96) hours to return to normothermia
(36.5°C). Women took around 6 h longer than men to return to normothermia
(mean = 11.14 h, SD = 5.58; mean = 5.38 h, SD = 4.41). Positive correlations were
noted between TBSA%, the length of time between admission to the ED and the
intensive care unit, and the hours taken to reach normothermia. Regression
analysis suggests the initial recorded temperature on admission to the ED was the
main predictor of the time body temperature takes to return to normothermia
(β = .513, p < .001).
CONCLUSION: This study provides information for practice changes by highlighting
the need for guidelines and education programs for health professionals to ensure
the delivery of optimum care to people with burn injury.
Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by
Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.aucc.2021.05.005
PMID: 34167888
Conflict of interest statement: Conflict of Interest The authors have no conflict
of interest to declare.
