Miller Clemens, Bräuer Anselm, Wieditz Johannes, Nemeth Marcus
Department of Anesthesiology, University Medical Center Goettingen, Robert-Koch-Straße 40, 37075, Goettingen, Germany.
Department of Anesthesiology, Children's Orthopedic Hospital Aschau im Chiemgau, Bernauer Straße 18, 83229, Aschau im Chiemgau, Germany.
J Clin Monit Comput. 2024 Dec 19. doi: 10.1007/s10877-024-01254-y.
Given that perioperative normothermia represents a quality parameter in pediatric anesthesia, numerous studies have been conducted on temperature measurement, albeit with heterogeneous measurement intervals, ranging from 30 s to fifteen minutes. We aimed to determine the minimum time interval for reporting of intraoperative core body temperature across commonly used measurement intervals in children. Data were extracted from the records of 65 children who had participated in another clinical study and analyzed using a quasibinomial mixed linear model. Documented artifacts, like probe dislocations or at the end of anesthesia, were removed. Primary outcome was the respective probability of failing to detect a temperature change of 0.2 °C or more at any one measurement point at 30 s, one minute, two minutes, five minutes, ten minutes, and fifteen minutes, considering an expected probability of less than 5% to be acceptable. Secondary outcomes included the probabilities of failing to detect hypothermia (< 36.0 °C) and hyperthermia (> 38.0 °C). Following the removal of 4,909 exclusions, the remaining 222,366 timestamped measurements (representing just over 60 h of monitoring) were analyzed. The median measurement time was 45 min. The expected probabilities of failing to detect a temperature change of 0.2 °C or more were 0.2% [95%-CI 0.0-0.7], 0.5% [95%-CI 0.0-1.2], 1.5% [95%-CI 0.2-2.6], 4.8% [95%-CI 2.7-6.9], 22.4% [95%-CI 18.3-26.4], and 31.9% [95%-CI 27.3-36.4], respectively. Probabilities for the detection of hyperthermia (n = 9) were lower and omitted for hypothermia due to low prevalence (n = 1). In conclusion, the core body temperature should be reported at intervals of no more than five minutes to ensure the detection of any temperature change in normothermic ranges. Further studies should focus on hypothermic and hyperthermic ranges.
鉴于围手术期正常体温是小儿麻醉中的一项质量参数，已有众多关于体温测量的研究，尽管测量间隔各异，从30秒到15分钟不等。我们旨在确定儿童常用测量间隔下术中核心体温报告的最短时间间隔。数据从参与另一项临床研究的65名儿童的记录中提取，并使用准二项混合线性模型进行分析。记录的伪像，如探头脱位或麻醉结束时的伪像，被排除。主要结局是在30秒、1分钟、2分钟、5分钟、10分钟和15分钟的任一测量点未能检测到0.2°C或更高体温变化的各自概率，认为预期概率小于5%是可接受的。次要结局包括未能检测到体温过低（<36.0°C）和体温过高（>38.0°C）的概率。在排除4909个记录后，对剩余的222366个带时间戳的测量值（代表超过60小时的监测）进行了分析。中位测量时间为45分钟。未能检测到0.2°C或更高体温变化的预期概率分别为0.2%[95%置信区间0.0 - 0.7]、0.5%[95%置信区间0.0 - 1.2]、1.5%[95%置信区间0.2 - 2.6]、4.8%[95%置信区间2.7 - 6.9]、22.4%[95%置信区间18.3 - 26.4]和31.9%[95%置信区间27.3 - 36.4]。检测到体温过高的概率（n = 9）较低，由于体温过低的发生率较低（n = 1），故未列出其概率。总之，核心体温应每隔不超过5分钟报告一次，以确保检测到正常体温范围内的任何体温变化。进一步的研究应聚焦于体温过低和体温过高范围。
