Hecker R B, Brownfield R M, Rubal B J
Department of Nursing, Brooke Army Medical Center, Fort Sam Houston, Tex. 78234-6200, USA.
South Med J. 1996 Jan;89(1):71-7. doi: 10.1097/00007611-199601000-00013.
Measurement of body temperature in the postanesthesia care unit (PACU) is an important parameter in patient management. Failure to reach minimal acceptable body temperature standards has been associated with physiologic derangements, the application of additional therapy, and prolonged PACU stays. Newer methods to monitor temperature introduced into the PACU have been touted to be adequate for detecting clinically significant changes in temperature. In this study, skin core-temperature-corrected liquid crystal thermography (LCT), axillary (AT) electronic, and infrared tympanic membrane (ITT) temperatures were compared with oral thermistor thermometry (OT) in 205 PACU patients. Regression analysis suggests that when compared with the oral method, ITT tends to overestimate and AT and LCT tend to underestimate oral temperatures. Mean temperatures obtained by LCT (35.5 +/- 1.0 degrees C), AT (35.1 +/- 0.9 degrees C), and ITT (36.3 +/- 0.8 degrees C) differed significantly from OT (36.0 +/- 0.7 degrees C) mean temperatures. We applied Bayesian analysis to assess the sensitivity and specificity of each method, using a hypothermia reference of < 36 degrees C. Results suggest that the definition of hypothermia may depend on the modality used to assess body temperature in the PACU.
在麻醉后护理单元（PACU）测量体温是患者管理中的一个重要参数。未能达到最低可接受体温标准与生理紊乱、额外治疗的应用以及PACU停留时间延长有关。引入PACU的新型体温监测方法据称足以检测临床上显著的体温变化。在本研究中，对205例PACU患者的皮肤核心温度校正液晶热成像（LCT）、腋窝（AT）电子体温计和红外鼓膜（ITT）温度与口腔热敏电阻测温法（OT）进行了比较。回归分析表明，与口腔测温法相比，ITT往往高估体温，而AT和LCT往往低估口腔温度。LCT（35.5±1.0℃）、AT（35.1±0.9℃）和ITT（36.3±0.8℃）测得的平均温度与OT（36.0±0.7℃）的平均温度有显著差异。我们应用贝叶斯分析来评估每种方法的敏感性和特异性，采用体温低于36℃作为体温过低的参考标准。结果表明，体温过低的定义可能取决于在PACU中用于评估体温的方式。
