Joost Mette, Guldager Henrik
H:S Amager Hospital, Anaestesi- og Operationsafdelingen, Intensiv Afsnit, DK-2300 København S.
Ugeskr Laeger. 2003 May 26;165(22):2296-8.
The purpose of the study was to compare three different methods of assessing the core temperature: by measuring the bladder temperature, the tympanic temperature, (Braun Thermoscan 3000) and the forehead skin temperature (Philips SensorTouch). Measuring of the bladder temperature and the tympanic temperature are wellknown methods whereas measuring of the forehead skin temperature by the use of Sensor Touch is a fairly new method by which the temperature at the warmest area of the forehead is measured.
Forty-two randomly chosen adult patients who all had a bladder catheter with a thermometer and a normal urine output. The patients were admitted to an intensive care unit and none were intubated nasally. Otoscopy was performed prior to temperature measurement. The temperatures were measured almost simultaneously. At the same time a white blood cell count and the C-reactive-protein value was recorded.
There was a good linear coherence between the bladder temperature and the tympanic temperature (r = 0.97). The linear coherence between the bladder temperature and the forehead skin temperature was poor (r = 0.59). We found a mean deviation of 0.07 degree C and a standard deviation of 0.3 degree C of the difference between the bladder temperature and the tympanic temperature (p = 0.19). The mean of the difference between the bladder temperature and the forehead skin temperature was 0.5 degree C and a standard deviation of 0.8 degree C (p = 0.0003). Furthermore the forehead skin thermometer was not able to measure temperatures < 35.0 degrees C. We found no statistically significant coherence between the core temperature and the white blood cell count or C-reactive-protein.
Tympanic temperature was well coherent with bladder temperature--forehead skin temperature was poorly coherent with bladder temperature. By evaluating the core temperature in intensive care patients the tympanic temperature is a reliable alternative to the bladder temperature.
本研究的目的是比较三种不同的核心温度评估方法：通过测量膀胱温度、鼓膜温度（博朗耳温枪3000）和前额皮肤温度（飞利浦感应式体温计）。测量膀胱温度和鼓膜温度是众所周知的方法，而使用感应式体温计测量前额皮肤温度是一种相当新的方法，该方法测量的是前额最热区域的温度。
随机选取42名成年患者，他们均留置有带温度计的膀胱导管且尿量正常。患者入住重症监护病房，均未进行鼻插管。在测量体温前进行耳镜检查。体温测量几乎同时进行。同时记录白细胞计数和C反应蛋白值。
膀胱温度与鼓膜温度之间存在良好的线性相关性（r = 0.97）。膀胱温度与前额皮肤温度之间的线性相关性较差（r = 0.59）。我们发现膀胱温度与鼓膜温度之差的平均偏差为0.07摄氏度，标准差为0.3摄氏度（p = 0.19）。膀胱温度与前额皮肤温度之差的平均值为0.5摄氏度，标准差为0.8摄氏度（p = 0.0003）。此外，前额皮肤体温计无法测量低于35.0摄氏度的温度。我们未发现核心温度与白细胞计数或C反应蛋白之间存在统计学上的显著相关性。
鼓膜温度与膀胱温度相关性良好——前额皮肤温度与膀胱温度相关性较差。在评估重症监护患者的核心温度时，鼓膜温度是膀胱温度的可靠替代指标。
