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改进的零热通量核心温度监测在全身麻醉非心脏手术患者中的准确性

Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia.

作者信息

Liang Yan, Wang Jing-Yan, Shao Xin-Feng, Wang Ze-Guang, Gao Mei-Na, Liang Hao

机构信息

Department of Anesthesiology, Baoding No.1 Central Hospital, Northern Great Wall Street 320#, Baoding, 071000, Hebei, China.

Department of Otolaryngology, Affiliated Hospital of Hebei University, Baoding, 071000, China.

出版信息

Sci Rep. 2025 Jul 1;15(1):20595. doi: 10.1038/s41598-025-07314-w.

Abstract

Due to various factors such as anesthesia, the core body temperature of perioperative patients often fluctuates significantly. Ideal core temperature measurements are particularly needed during the perioperative period for early identification of hypothermia and malignant hyperthermia, and even to guide intraoperative temperature protection. This study aimed to evaluate the consistency of the optimized Zero-Heat-Flux (ZHF) thermometer with esophageal temperature monitoring under general anesthesia. Adult patients, classified as American Society of Anesthesiologists (ASA) I-III, who are scheduled for elective surgery will be enrolled in this study. Both esophageal and ZHF core temperature monitoring were measured simultaneously. The consistency and correlation between the two measurements were evaluated using Bland-Altman analysis, linear regression methods, and the percentage of differences within ± 0.5 °C. The sensitivity and specificity of the ZHF temperature in identifying hypothermia were further validated. Ninety patients with a total of 1035 pairs of measurements were analyzed. Bland-Altman analysis revealed a mean difference between ZHF temperature and esophageal temperature of 0.06 ± 0.26 °C, with 95% limits of agreement ranging from - 0.57 to 0.46 °C. 96.0% of the measurement differences were within ± 0.5 °C. The consistency correlation coefficient was 0.89 (95% CI 0.88-0.90). The sensitivity and specificity of ZHF temperature monitoring in diagnosing hypothermia were 0.86 and 0.91 respectively. The modified ZHF core temperature monitoring system demonstrates good accuracy and consistency with esophageal temperature monitoring during general anesthesia for surgery. ZHF temperature monitoring is highly reliable for diagnosing hypothermia, though further research is needed to evaluate its accuracy.

摘要

由于麻醉等多种因素,围手术期患者的核心体温常常会出现显著波动。在围手术期,特别需要理想的核心体温测量来早期识别体温过低和恶性高热,甚至指导术中体温保护。本研究旨在评估优化后的零热流(ZHF)温度计与全身麻醉下食管温度监测的一致性。计划进行择期手术、美国麻醉医师协会(ASA)分级为I - III级的成年患者将纳入本研究。同时测量食管和ZHF核心体温。使用Bland - Altman分析、线性回归方法以及±0.5°C范围内差异的百分比来评估两种测量之间的一致性和相关性。进一步验证ZHF温度在识别体温过低方面的敏感性和特异性。对90例患者共1035对测量值进行了分析。Bland - Altman分析显示,ZHF温度与食管温度的平均差异为0.06±0.26°C,95%一致性界限范围为 - 0.57至0.46°C。96.0%的测量差异在±0.5°C范围内。一致性相关系数为0.89(95%CI 0.88 - 0.90)。ZHF温度监测诊断体温过低的敏感性和特异性分别为0.86和0.91。改良后的ZHF核心体温监测系统在手术全身麻醉期间与食管温度监测显示出良好的准确性和一致性。ZHF温度监测在诊断体温过低方面高度可靠,不过仍需要进一步研究来评估其准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53f7/12216160/237e2b320d20/41598_2025_7314_Fig1_HTML.jpg

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