Gianni Carola, Atoui Moustapha, Mohanty Sanghamitra, Trivedi Chintan, Bai Rong, Al-Ahmad Amin, Burkhardt J David, Gallinghouse G Joseph, Hranitzky Patrick M, Horton Rodney P, Sanchez Javier E, Di Biase Luigi, Lakkireddy Dhanunjaya R, Natale Andrea
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Division of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, Kansas.
Heart Rhythm. 2016 Nov;13(11):2195-2200. doi: 10.1016/j.hrthm.2016.07.021. Epub 2016 Jul 20.
Luminal esophageal temperature monitoring is performed with a variety of temperature probes, but little is known about the relationship between the structure of a given probe and its thermodynamic characteristics.
The purpose of this study was to evaluate the difference in thermodynamics between a 9Fr standard esophageal probe and an 18Fr esophageal stethoscope.
In the experimental setting, each probe was submerged in a constant temperature water bath maintained at 42°C; in the patient setting, we monitored the temperature with both probes at the same time.
The time constant of the stethoscope was higher than that of the probe (33.5 vs 8.3 s). Compared to the probe, the mean temperature measured by the stethoscope at 10 seconds was significantly lower (22.5°C ± 0.4°C vs 33.5°C ± 0.3°C, P<.0001), whereas the time to reach the peak temperature was significantly longer (132.6 ± 5.9 s vs 38.8 ± 1.0 s, P<.0001). Even in the ablation cases we observed that when the esophageal probe reached a peak temperature of 39.6°C ± 0.3°C, the esophageal stethoscope still displayed a temperature of 37.3°C ± 0.2°C (a mean of 2.39°C ± 0.3°C lower, P<.0001), showing a <0.5°C increase in temperature half of the times.
The 18Fr esophageal stethoscope has a significantly slower time response compared to the 9Fr esophageal probe. In the clinical setting, this might result in a considerable underestimation of the luminal esophageal temperature with potentially fatal consequences.
食管腔内温度监测使用多种温度探头,但对于特定探头的结构与其热力学特性之间的关系知之甚少。
本研究旨在评估9Fr标准食管探头与18Fr食管听诊器在热力学方面的差异。
在实验环境中,将每个探头浸入保持在42°C的恒温水浴中;在患者环境中,我们同时使用两种探头监测温度。
听诊器的时间常数高于探头(33.5秒对8.3秒)。与探头相比,听诊器在10秒时测得的平均温度显著更低(22.5°C±0.4°C对33.5°C±0.3°C,P<0.0001),而达到峰值温度的时间显著更长(132.6±5.9秒对38.8±1.0秒,P<0.0001)。即使在消融病例中,我们观察到当食管探头达到39.6°C±0.3°C的峰值温度时,食管听诊器仍显示为37.3°C±0.2°C(平均低2.39°C±0.3°C,P<0.0001),半数情况下温度升高<0.5°C。
与9Fr食管探头相比,18Fr食管听诊器的时间响应明显更慢。在临床环境中,这可能导致食管腔内温度被严重低估,从而产生潜在的致命后果。