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婴儿和学步儿童患者非侵入性核心温度监测的准确性:一项前瞻性观察研究。

Accuracy of non-invasive core temperature monitoring in infant and toddler patients: a prospective observational study.

机构信息

Department of Anesthesiology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.

Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

J Anesth. 2024 Dec;38(6):848-854. doi: 10.1007/s00540-024-03404-7. Epub 2024 Sep 11.

Abstract

PURPOSE

Careful perioperative temperature management is important because it influences clinical outcomes. In pediatric patients, the esophageal temperature is the most accurate indicator of core temperature. However, it requires probe insertion into the body cavity, which is mildly invasive. Therefore, a non-invasive easily and continuously temperature monitor system is ideal. This study aimed to assess the accuracy of Temple Touch Pro™ (TTP), a non-invasive temperature monitoring using the heat flux technique, compared with esophageal (Tesoph) and rectal (Trect) temperature measurements in pediatric patients, especially in infants and toddlers.

METHODS

This single-center prospective observational study included 40 pediatric patients (< 3 years old) who underwent elective non-cardiac surgery. The accuracy of TTP was analyzed using Bland-Altman analysis and compared with Tesoph or Trect temperature measurements. The error was within ± 0.5 °C and was considered clinically acceptable.

RESULTS

The bias ± precision between TTP and Tesoph was 0.09 ± 0.28 °C, and 95% limits of agreement were  - 0.48 to 0.65 °C (error within ± 0.5 °C: 94.0%). The bias ± precision between TTP and Trect was 0.41 ± 0.38 °C and 95% limits of agreement were  - 0.35 to 1.17 °C (error within ± 0.5 °C: 68.5%). In infants, bias ± precision with 95% limits of agreement were 0.10 ± 0.30 °C with  - 0.50 to 0.69 °C (TTP vs. Tesoph) and 0.35 ± 0.29 °C with  - 0.23 to 0.92 °C (TTP vs. Trect).

CONCLUSION

Core temperature measurements using TTP in infants and toddlers were more accurate with Tesoph than with Trect. In the future, non-invasive TTP temperature monitoring will help perioperative temperature management in pediatric patients.

摘要

目的

围手术期的精细体温管理非常重要,因为它会影响临床结果。在儿科患者中,食管温度是核心温度最准确的指标。然而,它需要将探头插入体腔,这具有轻微的侵入性。因此,一种非侵入性、易于操作且连续的体温监测系统是理想的。本研究旨在评估 Temple Touch Pro(TTP)的准确性,TTP 是一种使用热通量技术的非侵入性体温监测方法,与儿科患者(特别是婴儿和幼儿)的食管(Tesoph)和直肠(Trect)温度测量相比。

方法

这项单中心前瞻性观察性研究纳入了 40 名接受择期非心脏手术的儿科患者(<3 岁)。使用 Bland-Altman 分析评估 TTP 的准确性,并与 Tesoph 或 Trect 温度测量进行比较。误差在±0.5°C 以内被认为具有临床可接受性。

结果

TTP 与 Tesoph 之间的偏差±精度为 0.09±0.28°C,95%一致性界限为-0.48 至 0.65°C(误差在±0.5°C 以内:94.0%)。TTP 与 Trect 之间的偏差±精度为 0.41±0.38°C,95%一致性界限为-0.35 至 1.17°C(误差在±0.5°C 以内:68.5%)。在婴儿中,95%一致性界限的偏差±精度为 0.10±0.30°C,范围为-0.50 至 0.69°C(TTP 与 Tesoph 相比)和 0.35±0.29°C,范围为-0.23 至 0.92°C(TTP 与 Trect 相比)。

结论

TTP 用于测量婴儿和幼儿的核心体温与 Tesoph 相比,与 Trect 相比更准确。未来,非侵入性 TTP 体温监测将有助于儿科患者的围手术期体温管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80e4/11584424/0f064b3e8005/540_2024_3404_Fig1_HTML.jpg

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