Fiorini Kyle, Tamasi Tanya, Dorie Justin, Hegazy Ahmed F, Lee Ting-Yim, Slessarev Marat
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Division of Critical Care, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Front Med (Lausanne). 2022 Apr 13;9:810825. doi: 10.3389/fmed.2022.810825. eCollection 2022.
Accurate monitoring of core body temperature is integral to targeted temperature management (TTM) following cardiac arrest. However, there are no reliable non-invasive methods for monitoring temperature during TTM.
We compared the accuracy and precision of a novel non-invasive Zero-Heat-Flux Thermometer (SpotOn™) to a standard invasive esophageal probe in a cohort of patients undergoing TTM post-cardiac arrest.
We prospectively enrolled 20 patients undergoing post-cardiac arrest care in the intensive care units at the London Health Sciences Centre in London, Canada. A SpotOn™ probe was applied on each patient's forehead, while an esophageal temperature probe was inserted, and both temperature readings were recorded at 1-min intervals for the duration of TTM.
We compared the SpotOn™ and esophageal monitors using the Bland-Altman analysis and the Pearson correlation, with accuracy set as a primary outcome. Secondary outcomes included precision and correlation. Bias exceeding 0.1°C and limits of agreement exceeding 0.5°C were considered clinically important.
Sixteen (80%) of patients had complete data used in the final analysis. The median (interquartile range) duration of recording was 38 (12-56) h. Compared to the esophageal probe, SpotOn™ had a bias of 0.06 ± 0.45°C and 95% limits of agreement of -0.83 to 0.95°C. The Pearson correlation coefficient was 0.97 (95% confidence interval 0.9663-0.9678), with a two-tailed < 0.0001.
The SpotOn™ is an accurate method that may enable non-invasive monitoring of core body temperature during TTM, although its precision is slightly worse than the predefined 0.5°C when compared to invasive esophageal probe.
准确监测核心体温是心脏骤停后目标温度管理（TTM）的重要组成部分。然而，在TTM期间没有可靠的非侵入性温度监测方法。
我们在一组心脏骤停后接受TTM的患者中，将一种新型非侵入性零热流温度计（SpotOn™）与标准侵入性食管探头的准确性和精密度进行了比较。
设计、设置和参与者：我们前瞻性地纳入了加拿大伦敦伦敦健康科学中心重症监护病房中20名接受心脏骤停后护理的患者。在每位患者的前额上应用SpotOn™探头，同时插入食管温度探头，并在TTM期间每隔1分钟记录一次两个温度读数。
我们使用Bland-Altman分析和Pearson相关性比较了SpotOn™和食管监测器，将准确性设定为主要结局。次要结局包括精密度和相关性。偏差超过0.1°C和一致性界限超过0.5°C被认为具有临床重要性。
16名（80%）患者的数据用于最终分析。记录的中位（四分位间距）持续时间为38（12 - 56）小时。与食管探头相比，SpotOn™的偏差为0.06±0.45°C，95%一致性界限为-0.83至0.95°C。Pearson相关系数为0.97（95%置信区间0.9663 - 0.9678），双尾P<0.0001。
SpotOn™是一种准确的方法，可能能够在TTM期间对核心体温进行非侵入性监测，尽管与侵入性食管探头相比，其精密度略逊于预先定义的0.5°C。
