Anaesthesiology and Intensive Care Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Clin Monit Comput. 2023 Oct;37(5):1153-1159. doi: 10.1007/s10877-023-00984-9. Epub 2023 Mar 6.
Zero-heat-flux core temperature measurements on the forehead (ZHF-forehead) show acceptable agreement with invasive core temperature measurements but are not always possible in general anesthesia. However, ZHF measurements over the carotid artery (ZHF-neck) have been shown reliable in cardiac surgery. We investigated these in non-cardiac surgery. In 99 craniotomy patients, we assessed agreement of ZHF-forehead and ZHF-neck (3M™ Bair Hugger™) with esophageal temperatures. We applied Bland-Altman analysis and calculated mean absolute differences (difference index) and proportion of differences within ± 0.5 °C (percentage index) during entire anesthesia and before and after esophageal temperature nadir. In Bland-Altman analysis [mean (limits of agreement)], agreement with esophageal temperature during entire anesthesia was 0.1 (-0.7 to +0.8) °C (ZHF-neck) and 0.0 (-0.8 to +0.8) °C (ZHF-forehead), and, after core temperature nadir, 0.1 (-0.5 to +0.7) °C and 0.1 (-0.6 to +0.8) °C, respectively. In difference index [median (interquartile range)], ZHF-neck and ZHF-forehead performed equally during entire anesthesia [ZHF-neck: 0.2 (0.1-0.3) °C vs ZHF-forehead: 0.2 (0.2-0.4) °C], and after core temperature nadir [0.2 (0.1-0.3) °C vs 0.2 (0.1-0.3) °C, respectively; all p > 0.017 after Bonferroni correction]. In percentage index [median (interquartile range)], both ZHF-neck [100 (92-100) %] and ZHF-forehead [100 (92-100) %] scored almost 100% after esophageal nadir. ZHF-neck measures core temperature as reliably as ZHF-forehead in non-cardiac surgery. ZHF-neck is an alternative to ZHF-forehead if the latter cannot be applied.
额部零热流量（ZHF-forehead）核心温度测量与有创核心温度测量具有良好的一致性，但在全身麻醉中并不总是可行。然而，在心脏手术中，颈动脉（ZHF-neck）的 ZHF 测量已被证明是可靠的。我们在非心脏手术中对此进行了研究。在 99 例开颅手术患者中，我们评估了额部 ZHF-forehead 和颈部 ZHF-neck（3M™ Bair Hugger™）与食管温度的一致性。我们应用 Bland-Altman 分析，并计算了整个麻醉期间以及食管温度最低点前后的平均绝对差值（差值指数）和差值在±0.5°C 内的比例（百分比指数）。在 Bland-Altman 分析中（平均值[一致性界限]），整个麻醉期间与食管温度的一致性为 0.1（-0.7 至+0.8）°C（ZHF-neck）和 0.0（-0.8 至+0.8）°C（ZHF-forehead），而在核心温度最低点后，分别为 0.1（-0.5 至+0.7）°C 和 0.1（-0.6 至+0.8）°C。在差值指数[中位数（四分位距）]方面，整个麻醉期间 ZHF-neck 和 ZHF-forehead 的表现相当[ZHF-neck：0.2（0.1-0.3）°C 与 ZHF-forehead：0.2（0.2-0.4）°C]，在核心温度最低点后也如此[0.2（0.1-0.3）°C 与 0.2（0.1-0.3）°C，均 P＞0.017 （Bonferroni 校正后）。在百分比指数[中位数（四分位距）]方面，在食管最低点后，两者均接近 100%[ZHF-neck：100（92-100）%；ZHF-forehead：100（92-100）%]。ZHF-neck 在非心脏手术中与 ZHF-forehead 一样可靠地测量核心温度。如果无法应用 ZHF-forehead，则 ZHF-neck 是一种替代方法。
