Liang Hao, Wang Jing-Yan, Liang Yan, Shao Xin-Feng, Ding Yan-Ling, Jia Hui-Qun
Department of Anesthesiology, The Fourth Hospital Of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of ENT, Affiliated Hospital Of Hebei University, Baoding, Hebei, China.
J Clin Monit Comput. 2024 Feb;38(1):197-203. doi: 10.1007/s10877-023-01078-2. Epub 2023 Oct 4.
To identify and prevent perioperative hypothermia, most surgical patients require a non-invasive, accurate, convenient, and continuous core temperature method, especially for patients undergoing major surgery. This study validated the precision and accuracy of a cutaneous zero-heat-flux thermometer and its performance in detecting intraoperative hypothermia. Adults undergoing major non-cardiac surgeries with general anaesthesia were enrolled in the study. Core temperatures were measured with a zero-heat-flux thermometer, infrared tympanic membrane thermometer, and oesophagal monitoring at 15-minute intervals. Taking the average value of temperature measured in the tympanic membrane and oesophagus as a reference, we assessed the agreement using the Bland-Altman analysis and linear regression methods. Sensitivity, specificity, and predictive values of detecting hypothermia were estimated. 103 patients and one thousand sixty-eight sets of paired temperatures were analyzed. The mean difference between zero-heat-flux and the referenced measurements was -0.03 ± 0.25 °C, with 95% limits of agreement (-0.52 °C, 0.47 °C) was narrow, with 94.5% of the differences within 0.5 °C. Lin's concordance correlation coefficient was 0.90 (95%CI 0.89-0.92). The zero-heat-flux thermometry detected hypothermia with a sensitivity of 82% and a specificity of 90%. The zero-heat-flux thermometer is in good agreement with the reference core temperature based on tympanic and oesophagal temperature monitoring in patients undergoing major surgeries, and appears high performance in detecting hypothermia.
为了识别和预防围手术期体温过低，大多数手术患者需要一种非侵入性、准确、便捷且能持续监测核心体温的方法，对于接受大手术的患者尤为如此。本研究验证了一种皮肤零热流温度计的精度和准确性及其在检测术中体温过低方面的性能。纳入了接受全身麻醉的非心脏大手术的成人患者。每隔15分钟用零热流温度计、红外鼓膜温度计和食管监测仪测量核心体温。以鼓膜和食管测量温度的平均值作为参考，我们使用Bland-Altman分析和线性回归方法评估一致性。估计检测体温过低的敏感性、特异性和预测值。分析了103例患者和1068组配对温度。零热流测量值与参考测量值之间的平均差异为-0.03±0.25°C，95%一致性界限为（-0.52°C，0.47°C），范围较窄，94.5%的差异在0.5°C以内。Lin一致性相关系数为0.90（95%CI 0.89-0.92）。零热流测温法检测体温过低的敏感性为82%，特异性为90%。在接受大手术的患者中，零热流温度计与基于鼓膜和食管温度监测的参考核心体温具有良好的一致性，并且在检测体温过低方面表现出高性能。
