Temporal and spatial dispersion of human body temperature during deep hypothermia
Open accessAbstract
Background Clinical temperature management remains challenging. Choosing the right sensor location to determine the core body temperature is a particular matter of academic and clinical debate. This study aimed to investigate the relationship of measured temperatures at different sites during surgery in deep hypothermic patients.Methods In this prospective single-centre study, we studied 24 patients undergoing cardiothoracic surgery: 12 in normothermia, 3 in mild, and 9 in deep hypothermia. Temperature recordings of a non-invasive heat flux sensor at the forehead were compared with the arterial outlet temperature of a heart-lung machine, with the temperature on a conventional vesical bladder thermistor and, for patients undergoing deep hypothermia, with oesophageal temperature.Results Using a linear model for sensor comparison, the arterial outlet sensor showed a difference among the other sensor positions between -0.54 and -1.12°C. The 95% confidence interval ranged between 7.06 and 8.82°C for the upper limit and -8.14 and -10.62°C for the lower limit. Because of the hysteretic shape, the curves were divided into phases and fitted into a non-linear model according to time and placement of the sensors. During cooling and warming phases, a quadratic relationship could be observed among arterial, oesophageal, vesical, and cranial temperature recordings, with coefficients of determination ranging between 0.95 and 0.98 (standard errors of the estimate 0.69-1.12°C).Conclusion We suggest that measured surrogate temperatures as indices of the cerebral temperature (e.g. vesical bladder temperature) should be interpreted with respect to the temporal and spatial dispersion during cooling and rewarming phases.
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The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space.
“The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space [44–48].”
The Tcore heat-flux sensor is a validated device.
“a validated heat-flux sensor (Tcore, Dräger, Germany), connected to a miniaturized data logger (HFUM, KORA Industrie Elektronik, Germany) [44–48]”
The Double Sensor provides a reliable and valid estimate of core body temperature.
“This approach has been tested in various space analogs and clinical settings and has been found to provide a reliable and valid estimate of CBT20–23.”
From Increased core body temperature in astronauts during long-duration space missions (2017) · cites this paper as [23]
The sensor probe applied to the forehead is a highly accurate surrogate compared to nasopharyngeal, esophageal and artery temperatures.
“Importantly, the sensor probe can be applied to the forehead, and has been shown to be highly accurate surrogate compared to nasopharyngeal20, esophageal23–27 and artery temperatures24.”
From Increased core body temperature in astronauts during long-duration space missions (2017) · cites this paper as [23]
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- Authors
- Opatz, O., Trippel, T., Lochner, A., Werner, A., Stahn, A., Steinach, M., Lenk, J., Kuppe, H., & Gunga, H. C.
- Affiliations
- Stiftung Charité (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Deutsches Herzzentrum der Charité (DE)
- Corresponding author
- Opatz, O.
- Venue
- British Journal of Anaesthesia
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 111
- Issue
- 5
- Pages
- 768-775
- ISSN
- 0007-0912 (ISSN-L)
- OpenAlex
- W2135616252
- Cited by
- 22
- References
- 35
- Citations by year
- 2023: 3 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 2 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 2
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- British Journal of Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- German Aerospace Agency (DLR) (50WB1030)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- deep hypothermia, core body temperature, esophageal temperature, heart-lung machine, cardiothoracic surgery, brain temperature, temperature dispersion, non-invasive temperature monitoring
- MeSH terms
- Adult, Aged, Aged, 80 and over, Algorithms, Anesthesia, General, Urinary Bladder, Blood Physiological Phenomena, Body Temperature, Esophagus, Female, Forehead, Heart Diseases, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Prospective Studies, Skin Temperature, Linear Models, Monitoring, Intraoperative, Echocardiography, Transesophageal, Nonlinear Dynamics, Thoracic Surgical Procedures, Circulatory Arrest, Deep Hypothermia Induced
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