Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
Crit Care Med. 2010 Jul;38(7):1569-73. doi: 10.1097/CCM.0b013e3181e47a20.
When treating patients with cardiac arrest with mild therapeutic hypothermia, a reliable and easy-to-use temperature probe is desirable. This study was conducted to investigate the accuracy and safety of tracheal temperature as a measurement of body temperature.
Observational cohort study.
Emergency department of a tertiary care university hospital.
Patients successfully resuscitated from cardiac arrest intended for mild hypothermia therapy.
Intubation was performed with a newly developed endotracheal tube that contains a temperature sensor inside the cuff surface. During the cooling, mild hypothermia maintenance, and rewarming phases, the temperature was recorded minute by minute. These data were compared with the temperature assessed by esophageal and blood temperature probes. Thereafter, tracheoscopy was performed to evaluate the condition of the tracheal mucosa.
Approximately 2000 measurements per temperature sensor per patient were recorded in 21 patients. The mean bias between the blood temperature and the tracheal temperature was -0.16 degrees C (limits of agreement: -0.36 degrees C to 0.04 degrees C). The mean bias between the esophageal and tracheal temperatures was -0.22 degrees C (limits of agreement: -0.49 degrees C to 0.07 degrees C). Agreement between temperature probes investigated by the Bland-Altman method showed a mean bias of less than -(1/4) degrees C, and time lags assessed graphically by hysteresis plots were negligible. No clinically relevant injury to the tracheal mucosa was detected.
Temperature monitoring at the cuff surface of an endotracheal tube is safe and provides accurate and reliable data in all phases of therapeutically induced mild hypothermia after cardiac arrest.
在对心脏骤停患者进行轻度治疗性低温治疗时,需要使用可靠且易于使用的温度探头。本研究旨在探讨气管温度作为体温测量的准确性和安全性。
观察性队列研究。
三级护理大学医院的急诊室。
成功从心脏骤停中复苏并计划接受轻度低温治疗的患者。
使用新开发的含套囊表面内置温度传感器的气管内管进行插管。在冷却、维持轻度低温和复温阶段,每分钟记录一次温度。将这些数据与食管和血液温度探头评估的温度进行比较。之后,进行气管镜检查以评估气管黏膜的状况。
在 21 名患者中,每个温度传感器每个患者记录了大约 2000 次测量值。血液温度与气管温度之间的平均偏差为-0.16°C(一致性界限:-0.36°C 至 0.04°C)。食管温度与气管温度之间的平均偏差为-0.22°C(一致性界限:-0.49°C 至 0.07°C)。通过 Bland-Altman 方法评估的温度探头之间的一致性显示平均偏差小于-(1/4)°C,滞后时间通过滞后图直观评估可忽略不计。未发现气管黏膜有任何临床相关损伤。
在心脏骤停后治疗性诱导轻度低温的所有阶段,气管内管套囊表面的温度监测是安全的,并提供准确可靠的数据。