DOI QR코드

DOI QR Code

Effects of local cold application on tissue & peripheral oxygen saturation, peripheral blood flow, skin temperature, and body temperature of healthy adult

국소적 냉 요법이 정상 성인의 조직과 말초의 산소포화도, 말초 혈류, 피부 온도, 체온에 미치는 효과

  • 김승옥 (한양대학교 일반대학원 간호학과) ;
  • 신용순 (한양대학교 간호학부)
  • Received : 2020.07.29
  • Accepted : 2020.10.05
  • Published : 2020.10.31

Abstract

Purpose: This study aimed to establish a basis for application time and cold therapy interval by checking the physiological changes after applying a cold-gel and ice pack, commonly applied to cold therapy, and after passive rewarming. Method: A total of 22 healthy adults used cold-gel packs and ice packs in a Randomized control group repeated measurement study, and passive rewarming was performed for 40 minutes after 30 minutes of cold therapy. After applying to the right axilla, StO2, SpO2, peripheral blood flow, skin and body temperature were measured 15 times every 5 minutes. Result: In the cold-gel pack group, StO2 decreased from 69.43% to 61.06% after 30 minutes application, and in the ice pack group, StO2 decreased from 67.66% to 64.80% (p <001). In the cold-gel pack group, skin temperature decreased from 33.57℃ to 29.15℃ after 30 minutes application, and in the ice pack group, skin temperature decreased from 32.64℃ to 28.90℃ (p <.001). Only skin temperature recovered completely after 40 minutes of rewarming. There were insignificant differences between the cold-gel pack and ice pack. Conclusion: When applying cold therapy to the axillary, at least 40 minutes for passive rewarming is necessary after 30 minutes of application.

목적: 본 연구는 국소적 냉 요법 중 가장 일반적으로 적용하는 냉 젤 팩과 얼음 팩을 적용 한 후와 수동적 재가온 후의 생리적 변화를 확인하여 냉 요법의 적용시간과 간격에 대한 근거를 마련하고자 합니다. 방법: 무작위 비교군 반복측정 실험연구로 건강한 성인 22명을 냉 젤 팩과 얼음 팩 그룹에 무작위 배정하여 30분 동안 냉요법을 적용한 후 40분 동안 수동 재가온을 실시했습니다. 오른쪽 액와에 냉요법이 적용되는 동안 5분 간격으로 총 15회, 조직과 말초의 산소포화도, 말초혈류, 피부온도, 체온을 측정하였습니다. 결과: 냉 젤 팩 군에서 StO2는 냉 요법 전 69.43%였고, 냉 젤 팩 적용 30분 후 61.06% 였으며 얼음 팩 군에서 StO2는 냉 요법 전 67.66%였고, 얼음 팩 적용 30분 후 64.80%로 크게 줄었습니다.(p <.001) 냉 젤 팩 군에서 피부온도는 냉 요법 전 33.57℃였고, 냉 젤 팩 적용 30분 후 29.15℃ 였으며 얼음 팩 군에서 피부온도는 냉 요법 전 32.64℃였고, 얼음 팩 적용 30분 후 28.90℃로 크게 줄었습니다.(p <.001) 40분 재가온 후에는 피부 온도만이 완전히 회복되었습다. 냉 젤 팩과 얼음 팩 그룹 간에는 큰 차이가 없었습니다. 결론: 액와에 국소적 냉 요법을 적용할 때는 30분 적용 후 적어도 40분 이상의 수동적 재가온을 위한 시간을 갖도록 해야 할 것입니다.

Keywords

References

  1. Butcher HK, Bulechek GM, Dochterman JM, Wagner CM. "Nursing interventions classification (NIC)". 7th ed. St. Louis, MO: Elsevier; p.214, 2018.
  2. Khoshnevis S, Craik NK, Diller KR. Cold-induced vasoconstriction may persist long after cooling ends: an evaluation of multiple cryotherapy units. Knee Surgery, Sports Traumatology, Arthroscopy. vol. 23, no.9, pp. 2475-2483, Sep, 2014. DOI: https://doi.org/10.1007/s00167-014-2911-y
  3. Adie S, Kwan A, Naylor JM, Harris IA, Mittal R. Cryotherapy following total knee replacement. Cochrane Database of Systematic Reviews. vol.12, no.9, 2012. DOI: https://doi.org/10.1002/14651858.CD007911.pub2
  4. East CE, Begg L, Henshall NE, Marchant PR, Wallace K. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database of Systematic Reviews. vol.12, 2012. DOI: https://doi.org/10.1002/14651858.CD006304.pub3
  5. Hammond NE, Boyle M. Pharmacological versus non-pharmacological antipyretic treatments in febrile critically ill adult patients: a systematic review and meta-analysis. Australian Critical Care. vol.24, no,1, pp.4-17. Feb, 2011. DOI: https://doi.org/10.1016/j.aucc.2010.11.002
  6. Modabber A, Rana M, Ghassemi A, Gerressen M, Gellrich NC, Holzle F, et al. Three-dimensional evaluation of postoperative swelling in treatment of zygomatic bone fractures using two different cooling therapy methods: a randomized, observer-blind, prospective study. Trials. vol.29, pp14-238, Jul, 2013, DOI: https://doi.org/10.1186/1745-6215-14-238
  7. Kilpatrick MM, Lowry DW, Firlik AD, Yonas H, Marion DW. Hyperthermia in the neurosurgical intensive care unit. Neurosurgery.vol.47,no.4, pp.855-856, Oct, 2000 DOI: .https://doi.org/10.1097/00006123-200010000-00011
  8. Jeon EJ, Lee HM, Cho SG, Kang HK, Kwak HW et al. Causes of Fever in the ICU - A Prospective, Cohort Study. Korean Journal of Critical Care Medicine. vol.23, no.1, pp.13-17, Jun, 2008. DOI: https://doi.org/10.4266/kjccm.2008.23.1.13
  9. Kallmunzer B, Krause C, Pauli E, Beck A, Breuer L, Kohrmann M, et al. Standardized antipyretic treatment in stroke: a pilot study. Cerebrovascular Disease. vol.31, no.4, pp.382-389, March, 2011. DOI: https://doi.org/10.1159/000321733
  10. Carney N, Totten AM, O'Reilly C, Ullman Js, Hawryluk GWJ, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury. Journal of Neurotrauma. VOL.80, N0.1, PP.6-15, Jan, 2017. DOI: https://doi.org/10.1227/NEU.0000000000001432
  11. Asgar PH, Yavuz M. Effects of peripheral cold application on core body temperature and haemodynamic parameters in febrile patients. International Journal of Nursing Practice. vol.20, no.2, pp.156-163, August,2014. DOI: https://doi.org/10.1111/ijn.12151
  12. Salgado PO, Silva LC, Silva PM, Chianca TC. Physical methods for the treatment of fever in critically ill patients: a randomized controlled trial. Revista da Escola de Enfermagem da USP. vol.50, no.5,pp. 823-830, 2016. DOI: https://doi.org/10.1590/s0080-623420160000600016
  13. Shin YS. Nursing protocols of cold application in different medical institutions in Korea. Journal of Korean Clinical Nursing Research. vol.21, pp.355-365, 2015. DOI: https://doi.org/10.22650/JKCNR.2015.21.3.355
  14. Lissoway JB, Lipman GS, Grahn DA, Cao VH, Shaheen M, Phan S, et al. Novel application of chemical cold packs for treatment of exercise-induced hyperthermia: a randomized controlled trial. Wilderness & Environmental Medicine. vol.26,no.2,pp.173-179,Jun, 2015. DOI: https://doi.org/10.1016/j.wem.2014.11.006
  15. Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient. Hawai'i Journal of Medicine & Public Health. vol.72, no.2, pp.237-241, 2013.
  16. Ko I. "Procedure for Fundamentals of Nursing". Seoul: Jeongdam Media; p.27, 2013.
  17. Chailler M, Ellis J, Stolarik A, Woodend K. Cold therapy for the management of pain associated with deep breathing and coughing post-cardiac surgery. Canadian Journal of Cardio-Nursing Practice Guidelines for Cold Application vascular Nursing. vol. 20, no. 2, pp. 18-24, 2010.
  18. Bleakley CM, O'Connor S, Tully MA, Rocke LG, Macauley DC, McDonough SM. The PRICE study (Protection Rest Ice Compression Elevation): design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946]. BMC Musculoskeletal Disorders. vol.19, pp.8-125, Dec, 2007. DOI: https://doi.org/10.1186/1471-2474-8-125
  19. Shin YS, Kim HJ, An JW, Lee Y. Development of evidence-based nursing practice guidelines for cold application in adult care. Korean Journal of Adult Nursing. vol.30, no.3, pp. 325-345, 2018. DOI: https://doi.org/10.7475/kjan.2018.30.3.325
  20. Ihsan M, Watson G, Lipski M, Abbiss CR. Influence of postexercise cooling on muscle oxygenation and blood volume changes. Medicine and Science in Sports and Exercise. vol.45, no.5, pp. :876-882, 2013. DOI: https://doi.org/10.1249/MSS.0b013e31827e13a2
  21. Enwemeka CS, Allen C, Avila P, Bina J, Konrade J, Munns S. Soft tissue thermodynamics before, during, and after cold pack therapy. Medicine and Science in Sports and Exercise. vol. 34, no.1, pp. 45-50, Jan, 2002. DOI: https://doi.org/10.1097/00005768-200201000-00008
  22. Knobloch K, Grasemann R, Jagodzinski M, Richter M, Zeichen J, Krettek C. Changes of achilles midportion tendon microcirculation after repetitive simultaneous cryotherapy and compression using a cryo/cuff. American Journal of Sports Medicine.. vol.34.,pp.1953-1959, 2006. DOI: https://doi.org/10.1177/0363546506293701
  23. Lilleby K, Garcia P, Gooley T, McDonnnell P, Taber R, Holmberg L, et al. A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Bone Marrow Transplantation. vol. 37, no. 11, pp.1031-1035, Jun, 2006. DOI: https://doi.org/10.1038/sj.bmt.1705384
  24. Music M, Finderle Z, Cankar K. Cold perception and cutaneous microvascular response to local cooling at different cooling temperatures. Microvascular Research. vol. 81, no. 3. pp. 319-324, May, 2011.. DOI: https://doi.org/10.1016/j.mvr.2011.01.004
  25. Kuo CC, Lin CC, Lee WJ, Huang WT. Comparing the antiswelling and analgesic effects of three different ice pack therapy durations: a randomized controlled trial on cases with soft tissue injuries. Journal of Nursing Research. vol. 21, no. 3, pp. 186-194, Sep, 2013.. DOI: http://dx.doi.org/10.1097/jnr.0b013e3182a0af12
  26. Chesterton LS, Foster NE, Ross L. Skin temperature response to cryotherapy. Archives of Physical Medicine and Rehabilitation. vol .83, no.4, pp.543-549, Apr, 2002 DOI: https://doi.org/10.1053/apmr.2002.30926
  27. Gorji HM, Nesami BM, Ayyasi M, Ghafari R, Yazdani J. Comparison of ice packs application and relaxation therapy in pain reduction during chest tube removal following cardiac surgery. North American Journal of Medical Sciences. vol.6, no.1, pp.19-24, Jan, 2014.. DOI; http://dx.doi.org/10.4103/1947-2714.125857
  28. Kim W, Kim J, Lee S, Jang O, Seo K, Kang H, et al. "Fundamentals of nursing interventions." Seoul: Soomoonsa; p.214, 2015.