Axillary Temperature, as Recorded by the iThermonitor WT701, Well Represents Core Temperature in Adults Having Noncardiac Surgery

作者：Pei, Lijian; Huang, Yuguang^*; Mao, Guangmei; Sessler, Daniel I.

来源：Anesthesia and Analgesia, 2018, 126(3): 833-838.

DOI：10.1213/ANE.0000000000002706

• CONCORDANCE CORRELATION-COEFFICIENT
• THERMAL MANAGEMENT
• CARDIAC-SURGERY
• ESOPHAGEAL
• HYPOTHERMIA
• THERMOREGULATION
• ANESTHESIA

BACKGROUND: Core temperature can be accurately measured from the esophagus or nasopharynx during general anesthesia, but neither site is suitable for neuraxial anesthesia. We therefore determined the precision and accuracy of a novel wireless axillary thermometer, the iThermonitor, to determine its suitability for use during neuraxial anesthesia and in other patients who are not intubated.
METHODS: We enrolled 80 adults having upper abdominal surgery with endotracheal intubation. Intraoperative core temperature was measured in distal esophagus and was estimated at the axilla with a wireless iThermonitor WT701 (Raiing Medical, Boston MA) at 5-minute intervals. Pairs of axillary and reference distal esophageal temperatures were compared and summarized using linear regression and repeated-measured Bland-Altman methods. We a priori determined that the iThermonitor would have clinically acceptable accuracy if most estimates were within 0.5 degrees C of the esophageal reference, and suitable precision if the limits of agreement were within 0.5 degrees C.
RESULTS: There were 3339 sets of paired temperatures. Axillary and esophageal temperatures were similar, with a mean difference (esophageal minus axillary) of only 0.14 degrees C +/- 0.26 degrees C (standard deviation). The Bland-Altman 95% limits of agreement were reasonably narrow, with the estimated upper limit at 0.66 degrees C and the lower limit at -0.38 degrees C, thus +/- 0.52 degrees C, indicating good agreement across the range of mean temperatures from 34.9 degrees C to 38.1 degrees C. The absolute difference was within 0.5 degrees C in 91% of the measurements (95% confidence interval, 88%-93%).
CONCLUSIONS: Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery and thus appears suitable for clinical use.

• 出版日期2018-3
• 单位中国医学科学院北京协和医院