新型无创核心体温监测系统Temple Touch Pro的评估
Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System.
作者信息
Evron Shmuel, Weissman Avi, Toivis Vadim, Shahaf Dana Baron, You Jing, Sessler Daniel I, Ezri Tiberiu
机构信息
From the *Department of Anesthesia, Wolfson Medical Center, Holon, affiliated to the Sackler Medical Faculty, Tel Aviv University, Israel; †Outcomes Research Consortium, Cleveland, Ohio; ‡Department of Anesthesiology, Rambam Health Care Campus, affiliated to The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel; §Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio; and ‖Department of Outcomes Research, Anesthesiology Institute, Cleveland, Ohio.
出版信息
Anesth Analg. 2017 Jul;125(1):103-109. doi: 10.1213/ANE.0000000000001695.
BACKGROUND
The Temple Touch Pro (TTP) is a novel system that estimates core temperature from skin over the temporal artery. We tested the hypothesis that this noninvasive system estimates core temperature to an accuracy within 0.5°C.
METHODS
Core temperature was continuously monitored in 50 adult and pediatric surgical patients by positioning the sensor patch of a TTP over one temporal artery. The sensor consists of a thermistor array near the skin surface, another set of thermistors above an insulator, and a second insulator between the upper unit and the environment. The sensor measures skin temperature and heat flux, from which the monitor unit estimates core temperature from a proprietary algorithm. Reference core temperature was measured from the esophagus or nasopharynx. We conducted agreement analysis between the TTP and the reference core temperature measurements using the 95% Bland-Altman limits of agreement for repeated measurement data. The proportion of all differences that were within 0.5°C and repeat measures concordance correlation coefficient (CCC) were estimated as well.
RESULTS
TTP and the reference core temperature measurements agreed well in both adults and pediatric patients. Bland-Altman plots showed no evidence of systematic bias or variability over the temperature from 35.2°C to 37.8°C. The estimated 95% lower and upper limits of agreement were -0.57°C (95% confidence interval [CI], -0.76 to -0.41) and 0.57°C (95% CI, 0.44 to 0.71), indicating good agreement between the 2 methods. Ninety-four percentage (95% CI, 87% to 99%) of the TTP temperatures were within 0.5°C of the reference temperature. Good agreement was also supported by an estimated repeated measures CCC of 0.82 (95% CI, 0.66 to 0.91). The TTP core temperature measurements also agreed well with nasopharyngeal reference temperatures.
CONCLUSIONS
The noninvasive TTP system is sufficiently accurate and reliable for routine intraoperative core temperature monitoring.
背景
Temple Touch Pro（TTP）是一种通过颞动脉处皮肤估计核心体温的新型系统。我们检验了这一非侵入性系统估计核心体温的准确性在0.5°C以内的假设。
方法
通过将TTP的传感器贴片置于50例成人及儿科手术患者的一条颞动脉上方，持续监测其核心体温。该传感器由靠近皮肤表面的热敏电阻阵列、绝缘体上方的另一组热敏电阻以及上部单元与环境之间的第二个绝缘体组成。传感器测量皮肤温度和热通量，监测单元据此通过专有算法估计核心体温。通过食管或鼻咽测量参考核心体温。我们使用重复测量数据的95%布兰德-奥特曼一致性界限，对TTP与参考核心体温测量值进行一致性分析。还估计了所有差值在0.5°C以内的比例以及重复测量一致性相关系数（CCC）。
结果
TTP与参考核心体温测量值在成人和儿科患者中均具有良好的一致性。布兰德-奥特曼图显示，在35.2°C至37.8°C的温度范围内，无系统偏差或变异性的证据。估计的95%一致性下限和上限分别为-0.57°C（95%置信区间[CI]，-0.76至-0.41）和0.57°C（95%CI，0.44至0.71），表明两种方法之间具有良好的一致性。94%（95%CI，87%至99%）的TTP温度在参考温度的0.5°C范围内。估计的重复测量CCC为0.82（95%CI，0.66至0.91），也支持了良好的一致性。TTP核心体温测量值与鼻咽参考温度也具有良好的一致性。
结论
非侵入性TTP系统对于术中常规核心体温监测具有足够的准确性和可靠性。
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