Low-temperature infiltration identified using infrared thermography in patients with subcutaneous edema revealed ultrasonographically: A case report

Evaluation of a thermosensitive liquid crystal film for catheterization site assessment immediately following chemotherapy administration: An observational study

PURPOSE

Extravasation incidence is exceptionally low; however, ulceration or necrosis occurs in severe cases, possibly requiring surgical treatment. Early extravasation signs and symptoms are not always evident on treatment day, and inflammation, which leads to ulceration or necrosis, may appear several days later. Therefore, to minimize damage, identification of high-risk groups is required. This study aims to investigate the relationship between subcutaneous edema which is an early extravasation sign, and skin surface temperature using a thermosensitive liquid crystal film.

METHODS

Patients receiving chemotherapy through a peripheral intravenous catheter were recruited. Subcutaneous tissue around the catheterization site was observed for the presence of subcutaneous edema by ultrasonography. During chemotherapy initiation, a thermosensitive liquid crystal film was placed on the catheterization site. Color changes of the film were observed, and each case was classified according to low-temperature distribution patterns. To investigate the factors associated with temperature distribution pattern, logistic regression analysis was performed using clinically selected independent variables.

RESULTS

Data from 63 patients were analyzed. No obvious extravasation was observed. Film analysis revealed 34 cases of broadening low-temperature area from the vein and 23 cases of non-broadening low-temperature area from the vein. Subcutaneous edema was observed in 18 patients: 17 with broadening low-temperature area from the vein and 1 with non-broadening low-temperature area from the vein. Subcutaneous edema was positively correlated with broadening low-temperature area from the vein.

CONCLUSION

Catheter site skin temperature distribution pattern during chemotherapy was associated with subcutaneous edema which is the early extravasation sign immediately after chemotherapy.

Detection of intravenous infiltration using impedance parameters in patients in a long-term care hospital

This study was aimed to evaluate the changes of impedance parameters of patients who were admitted to a long-term care hospital by measuring bioelectrical impedance. The subjects were 18 patients who had infusion therapy through peripheral intravenous (IV) catheters and had at least an infiltration. The impedance parameters were measured with a multi-channel impedance measuring instrument (Vector Impedance Meter) twice; at starting IV infusion after catheter insertion and infiltration detected. As results, the resistance (R) after infiltration significantly decreased compared to the initial resistance. At 50 kHz, the resistances were 498.2±79.3 [Ω] before infiltration and 369.4±85.6 [Ω] after infiltration. The magnitude of the reactance (X_C) decreased after infiltration. At 50 kHz, the measured reactance was -31.1±8.3 [Ω] before infiltration and -24.5±5.9 [Ω] after infiltration. The data points plotted in the R-X_C graph shifted from the first quadrant before infiltration to third quadrant after infiltration. Our findings suggest that bioelectrical impedance is an effective method for detection of infiltration in a noninvasive and quantitative manner.

Normative surface skin temperature changes due to blood redistribution: A prospective study

The continuing development and manufacture of infrared devices, together with improvements in thermal body mapping techniques have simplified surface skin thermography which is being used more extensively than ever before. Normative thermography data, however, remains incomplete. A normative blood redistribution range of skin temperatures was established for use as a reference for laboratory infrared thermography (IT), thermal body mapping, and mass fever screenings. 500 healthy volunteers participated in this prospective study. To determine the maximum range of the skin temperature changes due to the posture-related physiological blood redistribution, the volunteers were asked to keep one extremity up and another extremity down whilst lying, sitting, and standing. We obtained 6000 hand and 400 foot temperature readings. The normal temperature was 29.1 ± 0.6 °C for the middle fingers and 27.8 ± 0.7 °C for the toes. The physiological temperature change during body position changes ranged from 4 to 6 °C (fingers: 27-31 °C; toes: 26-32 °C). At normal room temperature, the surface skin temperature may vary within this range due to blood redistribution. These changes reflect the individual variability of vasomotor activity. This physiological range of temperatures should be taken into account during IT and other thermography-involved investigations.

Monitoring peripheral edema of heart failure patients at home: Device, algorithm, and clinic study

Continuous monitoring of heart failure (HF) patients is desirable in order to better manage their illness and reduce unnecessary hospitalization. A comprehensive cloud-based HF patient management system is proposed to collect patients' health status information and provide just-in-time intervention. To date, an HF patient edema monitoring system prototype, including the device and its algorithm, has been developed. The hardware features multiple sensors whose data are fused using an edema classification algorithm based on a standard linear solid (SLS) edematous tissue model. Clinical data have been collected and analyzed to verify the effectiveness of the hardware and software. While the analysis results show some promise, full validation of the device and the algorithm warrant further study.

Dedicated tool to assess the impact of a rhetorical task on human body temperature

INTRODUCTION

Functional infrared thermal imaging is a method widely used in medicine, including analysis of the mechanisms related to the effect of emotions on physiological processes. The article shows how the body temperature may change during stress associated with performing a rhetorical task and proposes new parameters useful for dynamic thermal imaging measurements MATERIALS AND METHODS: 29 healthy male subjects were examined. They were given a rhetorical task that induced stress. Analysis and processing of collected body temperature data in a spatial resolution of 256×512pixels and a temperature resolution of 0.1°C enabled to show the dynamics of temperature changes. This analysis was preceded by dedicated image analysis and processing methods RESULTS: The presented dedicated algorithm for image analysis and processing allows for fully automated, reproducible and quantitative assessment of temperature changes and time constants in a sequence of thermal images of the patient. When performing the rhetorical task, the temperature rose by 0.47±0.19°C in 72.41% of the subjects, including 20.69% in whom the temperature decreased by 0.49±0.14°C after 237±141s. For 20.69% of the subjects only a drop in temperature was registered. For the remaining 6.89% of the cases, no temperature changes were registered CONCLUSIONS: The performance of the rhetorical task by the subjects causes body temperature changes. The ambiguous temperature response to the given stress factor indicates the complex mechanisms responsible for regulating stressful situations. Stress associated with the examination itself induces body temperature changes. These changes should always be taken into account in the analysis of infrared data.

Continuous thermographic observation may predict extravasation in chemotherapy-treated patients

PURPOSE

Extravasation, or leakage of vesicant drugs into subcutaneous tissues, causes serious complications such as induration and necrosis in chemotherapy-treated patients. As macroscopic observation may overlook symptoms during infusion, we focused on skin temperature changes at puncture sites and studied thermographic patterns related to induration or necrosis caused by extravasation.

METHODS

Outpatients undergoing chemotherapy using peripheral intravenous catheters were enrolled in this prospective observational study. We filmed and classified infrared thermography movies of puncture sites during infusion; ultrasonography was also utilized at puncture sites to observe the subcutaneous condition. Multiple logistic regression analysis was performed to examine the association of thermographic patterns with induration or necrosis observed on the next chemotherapy day. Differences in patient characteristics, puncture sites, and infusions were analyzed by Mann-Whitney's U test and Fisher's exact test according to thermographic patterns.

RESULTS

Eight patients developed induration among 74 observations in 62 patients. Among six thermographic patterns, a fan-shaped lower temperature area gradually spreading from the puncture site (fan at puncture site) was significantly associated with induration. Ultrasonography revealed that catheters of patients with fan at puncture site remained in the vein at the end of infusion, indicating that the infusion probably leaked from the puncture site. Patients with fan at puncture site had no significant differences in characteristics and infusion conditions compared with those with the other five thermographic patterns.

CONCLUSION

We determined that fan at puncture site was related to induration caused by extravasation. Continuous thermographic observation may enable us to predict adverse events of chemotherapy.