Femoro-iliacal artery versus pulmonary artery core temperature measurement during therapeutic hypothermia: An observational study

Resuscitation ◽  
2013 ◽  
Vol 84 (6) ◽  
pp. 805-809 ◽  
Author(s):  
Danica Krizanac ◽  
Peter Stratil ◽  
David Hoerburger ◽  
Christoph Testori ◽  
Christian Wallmueller ◽  
...  
Keyword(s):  
Observational Study ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Therapeutic Hypothermia ◽  
Core Temperature

A comparison of five methods of temperature measurement in febrile intensive care patients

1995 ◽  
Vol 4 (4) ◽  
pp. 286-292 ◽  
Author(s):  
T Schmitz ◽  
N Bair ◽  
M Falk ◽  
C Levine
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Core Temperature ◽  
Rectal Temperature ◽  
False Negative ◽  
Negative Likelihood Ratio ◽  
Likelihood Ratios ◽  
Axillary Temperature ◽  
Intensive Care Patients

BACKGROUND: A clinically useful temperature measurement method should correlate well with the body's core temperature. Although previous investigators have studied temperature readings from different sites in hypothermic and normothermic patients, none have compared methods specifically in febrile patients. OBJECTIVE: To compare temperature measurement methods in febrile intensive care patients. METHODS: Temperature readings were obtained in rapid sequence from an electronic thermometer for oral and axillary temperature, rectal probe, infrared ear thermometer on "core" setting, and pulmonary artery catheter, approximately every hour during the day and every 4 hours at night. The sample consisted of 13 patients with pulmonary artery catheters and with temperatures of at least 37.8 degrees C. RESULTS: Rectal temperature correlated most closely with pulmonary artery temperature. Rectal temperature showed closest agreement with pulmonary artery temperature, followed by oral, ear-based, and axillary temperatures. Rectal and ear-based temperatures were most sensitive in detecting temperatures greater than 38.3 degrees C. Likelihood ratios for detecting hyperthermia were 5.32 for oral, 2.46 for rectal, and 1.97 for ear-based temperature. Rectal and ear-based temperatures had the lowest negative likelihood ratios, indicating the least chance of a false negative reading. Axillary temperature had a negative likelihood ratio of 0.86. CONCLUSIONS: Rectal temperature measurement correlates most closely with core temperature. If the rectal site is contraindicated, oral or ear-based temperatures are acceptable. Axillary temperature does not correlate well with pulmonary artery temperature. These results underscore the importance of consistency in method when establishing temperature trends, and of awareness of method when interpreting clinical data.

Abstract P136: Tracheal Temperature for Monitoring Core Temperature during Mild Hypothermia in Pigs

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Danica Krizanac ◽  
Moritz Haugk ◽  
Wolfgang Weihs ◽  
Michael Holzer ◽  
Keywan Bayegan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Core Temperature ◽  
Tracheal Tube ◽  
Mild Hypothermia ◽  
Temperature Monitoring ◽  
Surface Cooling ◽  
Significant Difference ◽  
Mean Differences

Purpose of the stud y: Early out-of-hospital induction of mild hypothermia after cardiac arrest needs an easy to use and accurate core temperature monitoring, which might be achievable with tracheal temperature measurement. The aim of the study was to evaluate which tracheal temperature site (Ttra) reflects best pulmonary artery temperature (Tpa) during the induction of mild hypothermia. Methods: Eight pigs (29 –38 kg) were anesthetized and intubated with a specially designed endotracheal tube with three temperature probes: Ttra1 was attached to the wall of the tube, 1 cm proximal to the cuff-balloon, without contact to the mucosa; Ttra2 and Ttra3 were placed on the cuff-balloon with tight contact to the mucosa, whereas Ttra3 was covered by a plastic tube to protect the mucosa. Core temperature was measured with a pulmonary artery catheter (Tpa). Pigs were cooled with a new surface cooling device (Emcoolspad®, Vienna, Austria). Data are presented as mean (±SD), and mean differences (95% CI). Results: Emcoolspad® decreased Tpa from 38.5°C to 33°C in 31±10 min, which translates into a cooling rate of 11.9±3.8°C/h. Overall mean differences of tracheal temperatures to pulmonary artery temperature (Tpa) are shown in table 1 . Ttra 1 showed the least difference to Tpa, followed by Ttra 2 and Ttra 3. There was a significant difference in temperature differences (Ttra-Tpa) related to temperature measurement site on the tracheal tube (p<0.007). Conclusions: The temperature probe proximal of the cuff (Ttra 1) reflects best pulmonary artery temperature. It seems to be an accurate surrogate for core temperature during the induction of mild hypothermia. The industry is asked to provide a tracheal tube with a temperature sensor for simple temperature monitoring during fast cooling to facilitate the implementation of mild hypothermia after cardiac arrest in the out-of-hospital setting.

Pre-Hospital Core Temperature Measurement in Accidental and Therapeutic Hypothermia

2014 ◽  
Vol 15 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Giacomo Strapazzon ◽  
Emily Procter ◽  
Peter Paal ◽  
Hermann Brugger
Keyword(s):  
Temperature Measurement ◽  
Therapeutic Hypothermia ◽  
Core Temperature

Temperature Measurement—Gold Standard

PEDIATRICS ◽  
1992 ◽  
Vol 90 (4) ◽  
pp. 649-649
Author(s):  
MARTIN E. WEISSE
Keyword(s):  
Temperature Measurement ◽  
Core Temperature ◽  
Conventional Method ◽  
Study Design ◽  
Rectal Temperature ◽  
Gold Standard ◽  
Relative Accuracy ◽  
Temperature Determination ◽  
Conventional Methods

To the Editor.— I would like to comment on the article by Freed and Fraley in the March 1992 issue of Pediatrics.1 I have no argument with their study design and in fact applaud them for using Altman and Bland's method of analysis. Their conclusions, as written, are correct, that the tympanic thermometer "is unreliable compared with conventional methods of temperature determination." The three issues that I would like to raise are: (1) the relative accuracy of rectal and tympanic temperatures in predicting core temperature, (2) rectal temperature as the "gold standard," and (3) axillary thermometry as an acceptable conventional method of clinical temperature.

Accuracy of infrared ear thermometry and other temperature methods in adults

1994 ◽  
Vol 3 (1) ◽  
pp. 40-54 ◽  
Author(s):  
RS Erickson ◽  
LT Meyer
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
High Variability ◽  
External Factors ◽  
University Teaching ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Bladder Temperature ◽  
Pulmonary Artery Catheters

OBJECTIVE: To compare the accuracy of infrared ear-based temperature measurement in relation to thermometer, ear position, and other temperature methods, with pulmonary artery temperature as the reference. METHODS: Ear-based temperature measurements were made with four infrared thermometers, three in the core mode and two in the unadjusted mode, each with tug and no-tug techniques. Pulmonary artery, bladder (n = 21), and axillary temperatures were read after each ear-based measurement and oral temperature was measured once when possible (n = 32). Subjects consisted of a convenience sample of 50 patients with pulmonary artery catheters who were in adult critical care units of a university teaching hospital. RESULTS: Ear-based measurements correlated well with pulmonary artery temperature (r = .87 to .91), although closeness of agreement differed among thermometer-mode combinations (mean offsets = -0.7 to 0.5 degree C) and had moderately high variability between subjects (SD = +/- 0.5 degree C) with all instruments. Use of an ear tug either made no difference or resulted in slightly lower readings. Bladder temperature was nearly identical to pulmonary artery temperature values (r = .99, offset = 0.0 +/- 0.2 degree C). Oral readings were slightly lower (r = .78, offset = -0.2 degree C) and axillary readings much more so (r = .80 to .82, offset = -0.7 degree C); both were highly variable (SD = +/- 0.6 degree C) and affected by external factors. CONCLUSIONS: Infrared ear thermometry is useful for clinical temperature measurement as long as moderately high variability between patients is acceptable. Readings differ among thermometers, although several instruments provide values close to pulmonary artery temperature in adults. Readings are not higher with an ear tug. Bladder temperature substitutes well for pulmonary artery temperature, whereas oral and axillary values may be influenced by external factors in the critical care setting.

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