Kimberger O, Thell R, Schuh M, Koch J, Sessler D I, Kurz A
Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Waehringer Gurtel 18-20, 1090 Vienna, Austria.
Br J Anaesth. 2009 Aug;103(2):226-31. doi: 10.1093/bja/aep134. Epub 2009 May 29.
Accurate measurement of core temperature is a standard component of perioperative and intensive care patient management. However, core temperature measurements are difficult to obtain in awake patients. A new non-invasive thermometer has been developed, combining two sensors separated by a known thermal resistance ('double-sensor' thermometer). We thus evaluated the accuracy of the double-sensor thermometer compared with a distal oesophageal thermometer to determine if the double-sensor thermometer is a suitable substitute.
In perioperative and intensive care patient populations (n=68 total), double-sensor measurements were compared with measurements from a distal oesophageal thermometer using Bland-Altman analysis and Lin's concordance correlation coefficient (CCC).
Overall, 1287 measurement pairs were obtained at 5 min intervals. Ninety-eight per cent of all double-sensor values were within +/-0.5 degrees C of oesophageal temperature. The mean bias between the methods was -0.08 degrees C; the limits of agreement were -0.66 degrees C to 0.50 degrees C. Sensitivity and specificity for detection of fever were 0.86 and 0.97, respectively. Sensitivity and specificity for detection of hypothermia were 0.77 and 0.93, respectively. Lin's CCC was 0.93.
The new double-sensor thermometer is sufficiently accurate to be considered an alternative to distal oesophageal core temperature measurement, and may be particularly useful in patients undergoing regional anaesthesia.
准确测量核心体温是围手术期和重症监护患者管理的标准组成部分。然而,在清醒患者中很难获得核心体温测量值。一种新型非侵入式温度计已经研发出来,它结合了两个由已知热阻隔开的传感器(“双传感器”温度计)。因此,我们将双传感器温度计与远端食管温度计的准确性进行了评估,以确定双传感器温度计是否是合适的替代品。
在围手术期和重症监护患者群体(共68例)中,使用布兰德-奥特曼分析和林氏一致性相关系数(CCC)将双传感器测量值与远端食管温度计的测量值进行比较。
总体而言,每隔5分钟获得1287对测量值。所有双传感器值的98%在食管温度的±0.5℃范围内。两种方法之间的平均偏差为-0.08℃;一致性界限为-0.66℃至0.50℃。检测发热的敏感性和特异性分别为0.86和0.97。检测体温过低的敏感性和特异性分别为0.77和0.93。林氏CCC为0.93。
新型双传感器温度计足够准确,可被视为远端食管核心体温测量的替代方法,并且可能对接受区域麻醉的患者特别有用。