Department of Emergency Medicine, Medical University of Vienna, Austria.
Resuscitation. 2010 Jan;81(1):87-92. doi: 10.1016/j.resuscitation.2009.10.006. Epub 2009 Nov 17.
Out-of-hospital induction of mild therapeutic hypothermia after cardiac arrest needs easy to use and accurate body temperature monitoring. The aim of the study was to evaluate the best temperature probe position on a specially designed tracheal tube, as compared to pulmonary artery temperature (Tpa) during cooling to mild hypothermia in pigs.
Eight swine (29-38 kg) were anesthetized and intubated with an endotracheal tube with three temperature probes: T1 was attached to the wall of the tube, 1cm proximal to the cuff-balloon, without contact to the mucosa; T2 and T3 were placed on the cuff-balloon with tight contact to the mucosa, T3 was covered by a small plastic tube to protect the mucosa against mechanical alterations. Body temperature was measured with a pulmonary artery catheter. Pigs were cooled from Tpa 38.5 to 33.0 degrees C with fast surface and slow endovascular cooling in a crossover design. To assess hysteresis, areas under the curve (AUC) were compared. Data are presented as mean and 95% confidence intervals.
Temperatures were not different either during fast surface (T1-Tpa: 0.1[-0.3 to 0.5] degrees C, T2-Tpa: 0.2[0.0 to 0.4] degrees C, T3-Tpa: 0.4[0.1 to 0.7] degrees C) or slow endovascular (T1-Tpa: -0.3[-0.5 to 0.2] degrees C, T2-Tpa: -0.1[-0.3 to 0.0] degrees C, T3-Tpa: -0.1[-0.5 to 0.3] degrees C) cooling. There was no difference in hysteresis related to the location of the temperature probes. Faster surface cooling correlated with a larger but not significantly different hysteresis between the probes.
Tracheal temperature is an accurate surrogate for body temperature during fast and slow cooling to mild hypothermia in pigs and regardless of the location of the temperature probe on the tube.
心脏骤停后院外诱导轻度治疗性体温过低需要易于使用和准确的体温监测。本研究的目的是评估在专门设计的气管导管上的最佳温度探头位置,与冷却至轻度低温期间的肺动脉温度(Tpa)相比。
8 头猪(29-38 公斤)麻醉并插入带有三个温度探头的气管内管:T1 附着在管壁上,距套囊球 1cm 处,与粘膜无接触;T2 和 T3 放置在套囊球上,与粘膜紧密接触,T3 用小塑料管覆盖,以防止粘膜受到机械改变。使用肺动脉导管测量体温。猪在交叉设计中进行快速表面和缓慢血管内冷却,从 Tpa 38.5 冷却至 33.0°C。为了评估滞后,比较了曲线下面积(AUC)。数据以平均值和 95%置信区间表示。
在快速表面(T1-Tpa:0.1[-0.3 至 0.5]°C,T2-Tpa:0.2[0.0 至 0.4]°C,T3-Tpa:0.4[0.1 至 0.7]°C)或缓慢血管内冷却(T1-Tpa:-0.3[-0.5 至 0.2]° C,T2-Tpa:-0.1[-0.3 至 0.0]° C,T3-Tpa:-0.1[-0.5 至 0.3]° C)期间,温度没有差异。温度探头位置的滞后无差异。更快的表面冷却与探头之间更大但不显著的滞后相关。
在猪快速和缓慢冷却至轻度低温期间,气管温度是体温的准确替代物,与管上温度探头的位置无关。