Janke David, Kagelmann Niklas, Storm Christian, Maggioni Martina A, Kienast Camilla, Gunga Hanns-Christian, Opatz Oliver
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Internal Medicine, Nephrology and Intensive Care, Berlin, Germany.
Front Med (Lausanne). 2021 May 5;8:666908. doi: 10.3389/fmed.2021.666908. eCollection 2021.
Precisely measuring the core body temperature during targeted temperature management after return of spontaneous circulation is mandatory, as deviations from the recommended temperature might result in side effects such as electrolyte imbalances or infections. However, previous methods are invasive and lack easy handling. A disposable, non-invasive temperature sensor using the heat flux approach (Double Sensor), was tested against the standard method: an esophagus thermometer. The sensor was placed on the forehead of adult patients ( = 25, M/F, median age 61 years) with return of spontaneous circulation after cardiac arrest undergoing targeted temperature management. The recorded temperatures were compared to the established measurement method of an esophageal thermometer. A paired -test was performed to examine differences between methods. A Bland-Altman-Plot and the intraclass correlation coefficient were used to assess agreement and reliability. To rule out possible influence on measurements, the patients' medication was recorded as well. Over the span of 1 year and 3 months, data from 25 patients were recorded. The -test showed no significant difference between the two measuring methods ( = 1.47, = 0.14, = 1,319). Bland-Altman results showed a mean bias of 0.02°C (95% confidence interval 0.00-0.04) and 95% limits of agreement of -1.023°C and 1.066°C. The intraclass correlation coefficient was 0.94. No skin irritation or allergic reaction was observed where the sensor was placed. In six patients the bias differed noticeably from the rest of the participants, but no sex-based or ethnicity-based differences could be identified. Influences on the measurements of the Double Sensor by drugs administered could also be ruled out. This study could demonstrate that measuring the core body temperature with the non-invasive, disposable sensor shows excellent reliability during targeted temperature management after survived cardiac arrest. Nonetheless, clinical research concerning the implementation of the sensor in other fields of application should be supported, as well as verifying our results by a larger patient cohort to possibly improve the limits of agreement.
在自主循环恢复后的目标温度管理期间精确测量核心体温是必不可少的,因为偏离推荐温度可能会导致诸如电解质失衡或感染等副作用。然而,以前的方法具有侵入性且操作不便。一种使用热通量方法的一次性非侵入式温度传感器(双传感器)与标准方法——食管温度计进行了对比测试。该传感器放置在心脏骤停后自主循环恢复且正在接受目标温度管理的成年患者( = 25,男/女,中位年龄61岁)的前额上。将记录的温度与食管温度计的既定测量方法进行比较。进行配对检验以检查方法之间的差异。使用布兰德 - 奥特曼图和组内相关系数来评估一致性和可靠性。为了排除对测量可能的影响,还记录了患者的用药情况。在1年零3个月的时间里,记录了25名患者的数据。检验表明两种测量方法之间无显著差异( = 1.47, = 0.14, = 1,319)。布兰德 - 奥特曼结果显示平均偏差为0.02°C(95%置信区间0.00 - 0.04),一致性界限为 -1.023°C和1.066°C。组内相关系数为0.94。在传感器放置部位未观察到皮肤刺激或过敏反应。在6名患者中,偏差与其他参与者明显不同,但未发现基于性别或种族的差异。药物给药对双传感器测量的影响也可以排除。这项研究可以证明,使用这种非侵入式一次性传感器测量核心体温在心脏骤停存活后的目标温度管理期间具有出色的可靠性。尽管如此,仍应支持关于该传感器在其他应用领域实施的临床研究,并通过更大的患者队列验证我们的结果,以可能改善一致性界限。