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Yoon JU, Byeon GJ, Kim HY, Kim HJ, Yoo YM, Bae J, Lee J. Concordance of esophageal and tracheal temperatures in patients using breathing circuit with heated wire humidifier: A prospective observational study. Medicine (Baltimore) 2024; 103:e37166. [PMID: 38306513 PMCID: PMC10843427 DOI: 10.1097/md.0000000000037166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
RESULTS After excluding 4 patients with an anesthesia duration of < 2 hours, data from 34 patients (1163 sets of tracheal and esophageal temperatures) were analyzed. Concordance correlation coefficient was 0.78. The overall mean bias (95% limits of agreement) between the tracheal and esophageal temperatures was -0.16°C (-0.65°C to 0.34°C). The percentage of temperature differences within ± 0.25°C was 73.5% ± 32.3, with a median of 89.4% [0,100]. The linear mixed-effects model revealed that the estimated intercept was 0.17°C with a 95% confidence interval (CI) of 0.13°C to 0.22°C. The duration of anesthesia and the number of temperature measurements were associated with higher concordance between the tracheal and esophageal temperatures in univariate analysis.
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Affiliation(s)
- Ji-Uk Yoon
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Gyeong-Jo Byeon
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hee Young Kim
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hye-Jin Kim
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Yeong Min Yoo
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jaesang Bae
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jimin Lee
- Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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Yang SM, Cho HY, Kim HS. Comparison of tracheal temperature and core temperature measurement in living donor liver transplant recipients: a clinical comparative study. BMC Anesthesiol 2022; 22:315. [PMID: 36217113 PMCID: PMC9549662 DOI: 10.1186/s12871-022-01853-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Body temperature is a vital sign, and temperature monitoring during liver transplantation is important. Tracheal temperature can be measured via an endotracheal tube with a temperature sensor on the cuff of the tube. This study aimed to investigate the accuracy and trending ability of tracheal temperature measurement compared to those of the core temperature measured at the esophagus and pulmonary artery (PA) in living donor liver transplant recipients. METHODS Twenty-two patients who underwent living donor liver transplantation (LDLT) were enrolled. Patients were intubated using an endotracheal tube with a temperature sensor placed on the inner surface of the tube cuff. Tracheal, esophageal, and PA temperatures were recorded at five time points corresponding to the different phases of liver transplantation. The tracheal and esophageal, tracheal and PA, and esophageal and PA temperatures were compared using Bland-Altman analysis, four-quadrant plot/concordance analysis, and polar plot analysis. RESULTS Bland-Altman analysis showed an overall mean bias (95% limits of agreement) between tracheal and esophageal temperatures of -0.10 °C (-0.37 °C to 0.18 °C), with a percentage error of 0.27%; between tracheal and PA temperatures, -0.05 °C (-0.91 °C to 0.20 °C), with a percentage error of -0.15%; and between esophageal and PA temperatures, 0.04 °C (-0.27 °C to 0.35 °C), with a percentage error of 0.12%. The concordance rates between tracheal and esophageal temperatures, tracheal and PA temperatures, and esophageal and PA temperatures were 96.2%, 96.2%, and 94.94%, respectively. The polar plot analysis showed a mean angular bias (radial limits of agreement) of 4° (26°), -3° (13°), and 2° (21°). CONCLUSIONS Monitoring core temperature at the inner surface of the endotracheal tube cuff is accurate in all phases of LDLT with good trending ability; thus, it can be an excellent alternative for monitoring during LDLTs.
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Affiliation(s)
- Seong-Mi Yang
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hye-Yeon Cho
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hee-Soo Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Sung DS, Sim SY, Jin HW, Kwon WY, Kim KS, Kim T, Jung YS, Ko JI, Shin SM, Suh GJ, Park KS. Validation of non-invasive brain temperature estimation models during swine therapeutic hypothermia. Physiol Meas 2019; 40:025004. [PMID: 30523923 DOI: 10.1088/1361-6579/aaf0c1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This paper introduces a mathematical model that can estimate deep brain temperature during therapeutic hypothermia (TH) based on a double sensor method (DSM). Although the cerebral temperature is more important than the non-cerebral core temperature during TH, pulmonary artery (PA), rectal, and esophageal measurements (i.e. the typical core temperature measurement locations) have all been used for target temperature management. This is because there is no safe means of measuring the exact brain temperature. APPROACH We applied a double sensor thermometer to the subject's forehead to measure the cerebral temperature non-invasively. Invasive and non-invasive brain temperature readings were acquired for 11 pigs, seven of which were used to develop an optimal model using jackknife resampling and four of which were used to test the model. MAIN RESULTS The logit model exhibited the best performance of 0.134 °C root mean square error and a 0.993 Lin's concordance correlation coefficient (CCC). Each test dataset had acceptable results in that each 95% limit of agreement was within the range of clinical acceptance of [-0.5 °C, 0.5 °C]. Three of the four datasets yielded an 'almost perfect' score for Lin's CCC. SIGNIFICANCE Only a small number of studies have compared invasively and non-invasively measured brain temperatures, while most previous studies have concentrated on comparison with the core temperature. Furthermore, the possibility of measuring the exact brain temperature safely during TH using a DSM is shown in this work.
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Affiliation(s)
- Dong Suk Sung
- Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia
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Böl M, Leichsenring K, Ernst M, Ehret AE. Long-term mechanical behaviour of skeletal muscle tissue in semi-confined compression experiments. J Mech Behav Biomed Mater 2016; 63:115-124. [DOI: 10.1016/j.jmbbm.2016.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/02/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
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Guschlbauer M, Maul AC, Yan X, Herff H, Annecke T, Sterner-Kock A, Böttiger BW, Schroeder DC. Zero-Heat-Flux Thermometry for Non-Invasive Measurement of Core Body Temperature in Pigs. PLoS One 2016; 11:e0150759. [PMID: 26938613 PMCID: PMC4777531 DOI: 10.1371/journal.pone.0150759] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/18/2016] [Indexed: 11/29/2022] Open
Abstract
Hypothermia is a severe, unpleasant side effect during general anesthesia. Thus, temperature surveillance is a prerequisite in general anesthesia settings during experimental surgeries. The gold standard to measure the core body temperature (Tcore) is placement of a Swan-Ganz catheter in the pulmonary artery, which is a highly invasive procedure. Therefore, Tcore is commonly examined in the urine bladder and rectum. However, these procedures are known for their inaccuracy and delayed record of temperatures. Zero-heat-flux (ZHF) thermometry is an alternative, non-invasive method quantifying Tcore in human patients by applying a thermosensoric patch to the lateral forehead. Since the porcine cranial anatomy is different to the human’s, the optimal location of the patch remains unclear to date. The aim was to compare three different patch locations of ZHF thermometry in a porcine hypothermia model. Hypothermia (33.0°C Tcore) was conducted in 11 anesthetized female pigs (26-30kg). Tcore was measured continuously by an invasive Swan-Ganz catheter in the pulmonary artery (Tpulm). A ZHF thermometry device was mounted on three different defined locations. The smallest average difference between Tpulm and TZHF during stable temperatures was 0.21 ± 0.16°C at location A, where the patch was placed directly behind the eye. Also during rapidly changing temperatures location A showed the smallest bias with 0.48 ± 0.29°C. Location A provided the most reliable data for Tcore. Therefore, the ZHF thermometry patch should be placed directly behind the left temporal corner of the eye to provide a non-invasive method for accurate measurement of Tcore in pigs.
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Affiliation(s)
- Maria Guschlbauer
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Alexandra C. Maul
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
- * E-mail:
| | - Xiaowei Yan
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Holger Herff
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Thorsten Annecke
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anja Sterner-Kock
- Center for Experimental Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Daniel C. Schroeder
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
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Böl M, Ehret AE, Leichsenring K, Weichert C, Kruse R. On the anisotropy of skeletal muscle tissue under compression. Acta Biomater 2014; 10:3225-34. [PMID: 24636829 DOI: 10.1016/j.actbio.2014.03.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/18/2014] [Accepted: 03/04/2014] [Indexed: 11/28/2022]
Abstract
This paper deals with the role of the muscle fibres and extracellular matrix (ECM) components when muscle tissue is subjected to compressive loads. To this end, dissected tissue samples were tested in compression modes which induced states of fibres in compression (I), in tension (II) or at constant length (III), respectively. A comparison of the stress responses indicated that the tissue behaviour is significantly different for these modes, including differences between the modes (I) and (III). This contradicts the paradigm of many constitutive models that the stress response can be decomposed into an isotropic part relating to the ECM and an anisotropic fibre part the contribution of which can be neglected under compression. Conversely, the results provide experimental evidence that there is an anisotropic contribution of the fibre direction to the compressive stress. Interpreting these results in terms of recent microscopical studies, potential connections between the observed behaviour and the structure of muscle ECM are established.
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Affiliation(s)
- Markus Böl
- Institute of Solid Mechanics, Technische Universität Braunschweig, 38106 Braunschweig, Germany.
| | - Alexander E Ehret
- Institute of Solid Mechanics, Technische Universität Braunschweig, 38106 Braunschweig, Germany; Institute of Mechanical Systems, ETH Zurich, 8092 Zurich, Switzerland
| | - Kay Leichsenring
- Institute of Solid Mechanics, Technische Universität Braunschweig, 38106 Braunschweig, Germany
| | - Christine Weichert
- Institute of Solid Mechanics, Technische Universität Braunschweig, 38106 Braunschweig, Germany
| | - Roland Kruse
- Institute of Solid Mechanics, Technische Universität Braunschweig, 38106 Braunschweig, Germany
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Krizanac D, Stratil P, Hoerburger D, Testori C, Wallmueller C, Schober A, Haugk M, Haller M, Behringer W, Herkner H, Sterz F, Holzer M. Femoro-iliacal artery versus pulmonary artery core temperature measurement during therapeutic hypothermia: an observational study. Resuscitation 2012. [PMID: 23200998 DOI: 10.1016/j.resuscitation.2012.11.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM OF THE STUDY Therapeutic hypothermia after cardiac arrest improves neurologic outcome. The temperature measured in the pulmonary artery is considered to best reflect core temperature, yet is limited by invasiveness. Recently a femoro-arterial thermodilution catheter (PiCCO-Pulse Contour Cardiac Output) has been introduced in clinical practice as a safe and accurate haemodynamic monitoring system, which is also able to measure blood temperature. The aim of the study was to investigate, if the temperature measured with the PiCCO catheter reflects pulmonary artery temperature better than other sites during therapeutic hypothermia. METHODS In this observational study twenty patients after cardiac arrest and successful resuscitation were cooled with various cooling methods to 33 ± 1°C for 24h, followed by rewarming. Temperatures were recorded continuously in the pulmonary artery (Tpa), femoro-iliacal artery (Tpicco), ear canal (Tear), oesophagus (Toeso) and urinary bladder (Tbla). We assessed agreement of methods using the Bland Altman approach including bias and limits of agreement (LA). RESULTS All other sites differed significantly from Tpa with the bias varying from 0.4°C (Tbla) to -0.6°C (Tear). Standard deviations varied from 0.1°C (Tpicco, Toeso) to 0.5°C (Tear). For all sites bias was closer to zero with increasing average temperatures. Bias tended to be larger in the cooling phase compared to overall measurements. CONCLUSIONS Temperature measurement in the femoro-iliacal artery (Tpicco) reflects the gold standard of pulmonary artery temperature most accurately, especially during the cooling phase. Tpicco is easily accessible and might be used for monitoring core temperature without the need for additional temperature probes.
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Affiliation(s)
- Danica Krizanac
- Department of Emergency Medicine, Medical University of Vienna, Austria
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