Kimberger Oliver, Cohen Delphine, Illievich Udo, Lenhardt Rainer
Department of Anesthesia and Intensive Care, Medical University, Vienna, Austria.
Anesth Analg. 2007 Oct;105(4):1042-7, table of contents. doi: 10.1213/01.ane.0000281927.88935.e0.
Core temperature measurements are an important component of perioperative patient monitoring. It is fairly easy to obtain core temperature measurements invasively in anesthetized patients. However, such measurements are more difficult to obtain noninvasively in awake patients. Recently, a new version of a temporal artery thermometer for noninvasive core temperature measurements (TemporalScanner TAT-5000) was introduced with accuracy and precision advertised as being comparable to invasive core temperature measurements. In this study, we sought to determine if this new thermometer is an acceptable substitute for invasive bladder temperature measurement.
In 35 patients undergoing neurosurgical interventions and 35 patients in the neurosurgical intensive care unit, measurements from the temporal artery thermometer were compared with those from a bladder thermometer. Four measurements were obtained from each patient.
Overall 280 measurement pairs were obtained. The mean bias between the methods was 0.07 degrees C +/- 0.79 degrees C; the limits of agreement were approximately 3 times greater than the a priori defined limit of +/-0.5 degrees C (-1.48 to 1.62). The sensitivity for detecting fever (core temperature >37.8 degrees C) using the temporal artery thermometer was 0.72, and the specificity was 0.97. The positive predictive value for fever was 0.89; the negative predictive value was 0.94. The sensitivity for detecting hypothermia (core temperature <35.5 degrees C) was 0.29, and the specificity was 0.95. The positive predictive value for hypothermia was 0.31, and the negative predictive value was 0.95.
The results of this study do not support the use of temporal artery thermometry for perioperative core temperature monitoring; the temporal artery thermometer does not provide information that is an adequate substitute for core temperature measurement by a bladder thermometer.
核心体温测量是围手术期患者监测的重要组成部分。在麻醉患者中通过侵入性方式获取核心体温测量值相当容易。然而，在清醒患者中通过非侵入性方式获取此类测量值则更加困难。最近，推出了一种用于非侵入性核心体温测量的新型颞动脉体温计（TemporalScanner TAT - 5000），其宣传的准确性和精密度与侵入性核心体温测量相当。在本研究中，我们试图确定这种新型体温计是否可作为侵入性膀胱温度测量的可接受替代方法。
对35例接受神经外科手术干预的患者和35例神经外科重症监护病房的患者，将颞动脉体温计的测量结果与膀胱体温计的测量结果进行比较。每位患者获取4次测量值。
总共获得了280对测量值。两种方法之间的平均偏差为0.07℃±0.79℃；一致性界限约为预先定义的±0.5℃界限（-1.48至1.62）的3倍。使用颞动脉体温计检测发热（核心体温>37.8℃）的灵敏度为0.72，特异性为0.97。发热的阳性预测值为0.89；阴性预测值为0.94。检测体温过低（核心体温<35.5℃）的灵敏度为0.29，特异性为0.95。体温过低的阳性预测值为0.31，阴性预测值为0.95。
本研究结果不支持在围手术期核心体温监测中使用颞动脉测温法；颞动脉体温计所提供的信息不足以替代膀胱体温计测量核心体温。
