Calonder Emily M, Sendelbach Sue, Hodges James S, Gustafson Cindy, Machemer Carol, Johnson Donna, Reiland Lori
Abbott Northwestern Hospital, Minneapolis, MN 55407, USA.
J Perianesth Nurs. 2010 Apr;25(2):71-8. doi: 10.1016/j.jopan.2010.01.006.
Maintaining perioperative normothermia reduces postoperative complications. An accurate, noninvasive method to take temperatures representative of core temperature is needed. Oral thermometry is accepted as the most accurate means of non-core temperature assessment, but poses challenges in patients who are intubated or wearing oxygen masks. The purpose of this study was to determine the difference, if any, between core temperature as measured by an esophageal thermometer and temperatures measured by oral and temporal artery methods in patients undergoing colorectal or gynecology surgery. A repeated-measures design was used with a convenience sample of 23 patients undergoing colorectal or gynecology surgery. Two series of intraoperative temperatures were taken (oral and temporal artery thermometry) and compared with core temperature measured by esophageal probe. Repeated-measures analysis of variance tested for biases of oral or temporal temperatures versus core temperatures. Bland-Altman plots were drawn to test dependence of bias on actual core temperature. A priori, a temperature difference >0.4 degrees C was defined as clinically significant. Oral temperature was biased high relative to esophageal temperature by 0.12 degrees C on average (P = .0008; 95% confidence interval [0.061, 0.187]). Temporal artery temperature was biased high relative to esophageal, by 0.074 degrees C on average (P = .03; 95% confidence interval [0.010, 0.133]). Differences between core (esophageal) thermometry and oral or temporal artery thermometry were statistically significant but much smaller than the 0.4 degrees C identified as clinically acceptable. Oral and temporal artery temperatures are within the 0.4 degrees C of core (esophageal) temperatures, a difference that is considered clinically acceptable. Temperatures taken orally or by temporal artery thermometry are acceptable as noninvasive core measures for adult patients undergoing colorectal or gynecology surgery.
维持围手术期正常体温可减少术后并发症。因此需要一种准确、无创的方法来测量代表核心体温的温度。口腔测温被认为是最准确的非核心体温评估方法,但对于插管或佩戴氧气面罩的患者来说存在挑战。本研究的目的是确定在接受结直肠或妇科手术的患者中,食管温度计测量的核心体温与口腔和颞动脉测量的体温之间是否存在差异(若有)。采用重复测量设计,对23例接受结直肠或妇科手术的患者进行便利抽样。术中测量了两组体温(口腔和颞动脉测温),并与食管探头测量的核心体温进行比较。采用重复测量方差分析来检验口腔或颞部温度与核心温度之间的偏差。绘制Bland-Altman图以检验偏差对实际核心体温的依赖性。预先设定,温度差异>0.4℃被定义为具有临床意义。口腔温度相对于食管温度平均偏高0.12℃(P = .0008;95%置信区间[0.061, 0.187])。颞动脉温度相对于食管温度平均偏高0.074℃(P = .03;95%置信区间[0.010, 0.133])。核心(食管)测温与口腔或颞动脉测温之间的差异具有统计学意义,但远小于确定为临床可接受的0.4℃。口腔和颞动脉温度在核心(食管)温度的0.4℃范围内,这种差异被认为在临床上是可接受的。对于接受结直肠或妇科手术的成年患者,口腔或颞动脉测温所测温度可作为无创核心体温测量方法。