Indian journal of anaesthesia · 2018
Accuracy of skin temperature over carotid artery in estimation of core temperature in infants and young children during general anaesthesia.
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Suhail C K, Dave Nandini, Dias Raylene, Garasia Madhu
Аннотация
BACKGROUND AND AIMS: Core temperature monitoring is essential in children under general anaesthesia as they are more susceptible to hypothermia. We aimed to use skin temperature over the carotid artery (Tsk-carotid) with correction factors (Cf) to estimate core temperature. Primary outcome measure was to assess the sensitivity of Tsk-carotid with Cf for detecting hypothermia. Secondary outcome measure was to assess the specificity of Tsk-carotid with Cf for detecting hypothermia.
METHODS: First consecutive 50 patients fulfilling the inclusion criteria were included in modelling group and next 60 in the validation group. In the modelling group, average estimation error between Tsk-carotid and Tnaso was calculated and Cf was derived by multiple regression analysis (body surface area to mass ratio, body fat %, room temperature, relative humidity and warm Gamgee). In the validation group, Cf derived was used to predict Tnaso using Tsk-carotid by the formula: Tnaso-predicted = Tsk-carotid + Cf. Bland-Altman plots were used to assess the agreement between Tsk-carotid with Cf and Tnaso in the validation group.
RESULTS: The sensitivity for detecting hypothermia with the use of Tsk-carotid and Cf was 100%. The final Cf derived was 0.064 × (room temperature) -2.65. Most of the measurements fell within 95% confidence limit of Bland-Altman plot; 95% confidence interval (0.504-[-0.451]). The specificity of this method was 11%.
CONCLUSION: This method overestimated hypothermia in most cases and cannot be accurately used as a measure of core temperature monitoring perioperatively.
METHODS: First consecutive 50 patients fulfilling the inclusion criteria were included in modelling group and next 60 in the validation group. In the modelling group, average estimation error between Tsk-carotid and Tnaso was calculated and Cf was derived by multiple regression analysis (body surface area to mass ratio, body fat %, room temperature, relative humidity and warm Gamgee). In the validation group, Cf derived was used to predict Tnaso using Tsk-carotid by the formula: Tnaso-predicted = Tsk-carotid + Cf. Bland-Altman plots were used to assess the agreement between Tsk-carotid with Cf and Tnaso in the validation group.
RESULTS: The sensitivity for detecting hypothermia with the use of Tsk-carotid and Cf was 100%. The final Cf derived was 0.064 × (room temperature) -2.65. Most of the measurements fell within 95% confidence limit of Bland-Altman plot; 95% confidence interval (0.504-[-0.451]). The specificity of this method was 11%.
CONCLUSION: This method overestimated hypothermia in most cases and cannot be accurately used as a measure of core temperature monitoring perioperatively.