Neonatal Intensive Care Unit (Messrs Buccione and Scarponcini Fornaro and Drs Chiavaroli, Cicioni, and Di Valerio) and Vascular Surgery Unit (Ms Toracchio), Pescara Public Hospital, Pescara, Italy; Liggins Institute, University of Auckland, Auckland, New Zealand (Dr Chiavaroli); and Department of Health Sciences, University of Florence, Florence, Italy (Drs Rasero and Bambi).
Adv Neonatal Care. 2023 Oct 1;23(5):418-424. doi: 10.1097/ANC.0000000000001090. Epub 2023 Jul 13.
Neonatal encephalopathy is a clinical condition of altered neurological function in the first days of life. Targeted temperature management (TTM) is a validated approach to mitigate neurologic sequelae. Current literature suggests using rectal or esophageal site to assess temperature during TTM, but few studies focused on the best and the less invasive site to evaluate the temperature. This case report describes the performance of the bladder temperature monitoring during TTM.
A female newborn was born at 39 weeks' gestational age plus 4 days. At delivery, the newborn was in cardiorespiratory arrest.
After performing cardiopulmonary resuscitation and neurological examination, a hypoxic-ischemic encephalopathy was diagnosed.
After about 2 hours from birth, the newborn underwent TTM.
A total of 4642 measurements of rectal temperature and 4520 measurements of bladder temperature were collected. Agreement between the 2 sites was statistically significant with a mean difference of 0.064°C ± 0.219 (95% confidence interval, -0.364 to 0.494); F = 47.044; and P value of less than .001. Furthermore, difference between rectal and bladder sites was not influenced by patient's urine output ( F = 0.092, P = .762).
Bladder temperature seems to have a good reliability and not to be inferior to the other assessment site currently used. Using bladder catheter with temperature sensor could reduce the number of devices, ensure safer stabilization, and decrease treatment downtime.
新生儿脑病是生命最初几天神经功能改变的一种临床情况。目标温度管理（TTM）是一种经过验证的减轻神经后遗症的方法。目前的文献表明，在 TTM 期间使用直肠或食管部位来评估温度，但很少有研究关注评估温度的最佳和最微创部位。本病例报告描述了 TTM 期间膀胱温度监测的性能。
一名女性新生儿于 39 周加 4 天妊娠时出生。分娩时，新生儿出现心肺骤停。
在进行心肺复苏和神经系统检查后，诊断为缺氧缺血性脑病。
出生后约 2 小时，新生儿开始 TTM。
共采集了 4642 次直肠温度测量值和 4520 次膀胱温度测量值。两个部位之间的一致性具有统计学意义，平均差异为 0.064°C±0.219（95%置信区间，-0.364 至 0.494）；F=47.044；P 值小于 0.001。此外，患者尿量对直肠和膀胱部位之间的差异没有影响（F=0.092，P=0.762）。
膀胱温度似乎具有良好的可靠性，并不逊于目前使用的其他评估部位。使用带有温度传感器的膀胱导管可以减少设备数量，确保更安全的稳定，并减少治疗停机时间。
