Yamauchi M, Watanabe H, Imaizumi H, Sumita S, Yamakage M, Namiki A
Department of Anesthesiology, Sapporo Medical University School of Medicine.
Masui. 1995 Aug;44(8):1159-64.
During cardiac surgery, esophageal, rectal, or bladder temperature is usually monitored as an index of core temperature; however, these methods are invasive, and often inconsistently reflect the central body temperature, especially in pediatric patients. The purpose of this study was to evaluate the utility of tracheal temperature monitoring during cardiac surgery in pediatric patients. Fifteen children (ages; 8 m.-7 yr.) undergoing cardiac surgery with cardio-pulmonary bypass (CPB) were studied. Anesthesia was induced and maintained with high doses of fentanyl and intermittent doses of midazolam. After anesthetic induction, esophageal, rectal, bladder, tympanic, and forehead deep temperatures were monitored with a Core Temp Monitor (CTM-205, Terumo Co.). Simultaneously, the tracheal temperature was monitored with a specially made tracheal tube. A thermistor was attached by medical glue (Loctite Prism, Loctite Co.) at the anterior surface of a tracheal tube (Trachelon, Terumo Co.) without cuff (inside diameter 4.0-6.0 mm) where the tracheal tube tightly fits against the trachea. The inspired gas was warmed to 35 degrees C and humidified. During CPB, the blood temperature at the inlet to the patients was also recorded simultaneously. All indicated temperatures (Y) during CPB were analyzed for correlation with the blood temperature to the patients (X). The tracheal temperature had the highest correlation with the blood temperature from the patients (Y = 0.68X + 10.60, r = 0.89). There were also good correlations of the esophageal as well as bladder temperatures with blood temperature. There were no patients who suffered tracheal inflammation or laryngeal edema from the thermistor. Monitoring tracheal temperature is not only valuable for monitoring the core temperature, but also is convenient for pediatric patients in cardiac surgery.
在心脏手术期间，通常监测食管、直肠或膀胱温度作为核心温度的指标；然而，这些方法具有侵入性，并且常常不能一致地反映中心体温，尤其是在儿科患者中。本研究的目的是评估在儿科患者心脏手术期间监测气管温度的实用性。对15名接受体外循环（CPB）心脏手术的儿童（年龄8个月至7岁）进行了研究。麻醉诱导和维持采用高剂量芬太尼和间歇性咪达唑仑。麻醉诱导后，使用核心体温监测仪（CTM - 205，泰尔茂公司）监测食管、直肠、膀胱、鼓膜和前额深部温度。同时，使用特制的气管导管监测气管温度。通过医用胶水（乐泰棱镜，乐泰公司）将热敏电阻附着在无套囊（内径4.0 - 6.0 mm）的气管导管（特拉奇隆，泰尔茂公司）前表面，该气管导管紧密贴合气管。吸入气体加热至35摄氏度并加湿。在CPB期间，同时记录患者入口处的血液温度。分析CPB期间所有指示温度（Y）与患者血液温度（X）的相关性。气管温度与患者血液温度的相关性最高（Y = 0.68X + 10.60，r = 0.89）。食管和膀胱温度与血液温度也有良好的相关性。没有患者因热敏电阻而出现气管炎症或喉头水肿。监测气管温度不仅对监测核心温度有价值，而且对心脏手术中的儿科患者也很方便。
