van der Spek R D G, van Lingen R A, van Zoeren-Grobben D
Princess Amalia Department of Paediatrics, Division of Neonatology, Isala Clinics, Zwolle, The Netherlands.
Acta Paediatr. 2009 Feb;98(2):282-5. doi: 10.1111/j.1651-2227.2008.01063.x. Epub 2008 Oct 13.
An inadequate body temperature in preterm infants influences morbidity and mortality. Continuous rectal measurement is a reliable method to measure body temperature but might have adverse effects and is even contra-indicated in case of low platelets or necrotising enterocolitis. A save and non-invasive method to measure body temperature is the transcutaneous 'zero heat flow' method.
We hypothesised that for monitoring body temperature in very low birth weight (VLBW) infants, central measurement of temperature by way of the zero heat flow principle is just as reliable as rectal temperature.
Twenty-six infants, birth weight between 520 g and 1250 g, gestational age 25.28-32.28 weeks were provided with an insulated continuous skin probe with 'zero heat flow' and a continuous rectal probe. Both measurements were registered every hour over a period of 48 h. The sample size was calculated to detect a difference of less than or equal to 0.20 degrees C.
1205 of the 1248 temperature measurements were analysed. At any moment, skin temperature was higher or equal when compared to rectal temperature. Mean skin temperature was 0.13 degrees C (SD 0.33) higher than mean rectal temperature (t-test, p < 0.001). Correlation between rectal and skin temperature was 0.82 (p </= 0.05).
In VLBW infants, temperature measurement by 'zero heat flow' method is just as reliable as by rectal method.
早产儿体温过低会影响发病率和死亡率。持续直肠测温是测量体温的可靠方法,但可能有不良影响,在血小板减少或坏死性小肠结肠炎的情况下甚至是禁忌的。一种安全且无创的体温测量方法是经皮“零热流”法。
我们假设,对于监测极低出生体重(VLBW)婴儿的体温,通过零热流原理进行的中心体温测量与直肠体温测量一样可靠。
对26名出生体重在520克至1250克之间、胎龄为25.28 - 32.28周的婴儿,分别使用带有“零热流”的绝缘连续皮肤探头和连续直肠探头。在48小时内每小时记录一次两种测量结果。计算样本量以检测小于或等于0.20摄氏度的差异。
对1248次体温测量中的1205次进行了分析。在任何时刻,皮肤温度均高于或等于直肠温度。平均皮肤温度比平均直肠温度高0.13摄氏度(标准差0.33)(t检验,p < 0.001)。直肠温度与皮肤温度的相关性为0.82(p ≤ 0.05)。
在极低出生体重婴儿中,“零热流”法测量体温与直肠法一样可靠。