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Axillary and tympanic membrane temperature measurements are unreliable early after cardiopulmonary bypass

Published online by Cambridge University Press:  27 January 2006

T. A. Khan ,
H. A. Vohra ,
S. Paul ,
M. D. Rosin  and
R. L. Patel
T. A. Khan
Affiliation:
University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Department of Cardiothoracic Surgery, Coventry, UK
H. A. Vohra
Affiliation:
University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Department of Cardiothoracic Surgery, Coventry, UK
S. Paul
Affiliation:
University of Oxford, Diabetes Trial Unit, Oxford, UK
M. D. Rosin
Affiliation:
University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Department of Cardiothoracic Surgery, Coventry, UK
R. L. Patel
Affiliation:
University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave Hospital, Department of Cardiothoracic Surgery, Coventry, UK
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Extract

Summary

Background and objective: Inaccurate measurements of body temperature following cardiopulmonary bypass may be associated with serious complications. The purpose of this study was to determine whether axillary and tympanic temperature measurements correlate with the urinary bladder temperature in the early postcardiac surgery period. Methods: Forty-nine adult patients who underwent cardiac surgery under cardiopulmonary bypass at our institution were prospectively studied. Urinary bladder, right axillary, right tympanic and left tympanic temperature measurements were simultaneously recorded at 0, 6, 12 and 18 h following cardiopulmonary bypass. Patients had one to four sets of recordings and a total of 629 temperature measurements were recorded. The mean difference (bias) between the bladder and each of the other methods and limits of agreement were calculated using Bland and Altman method. Results: The mean core body temperature recorded from the bladder on admission to the intensive care unit was 36.4°C. After 6, 12 and 18 h the mean core body temperature was 37.4°C (range: 35.2–39.0), 37.5°C and 37.45°C, respectively. The mean differences (bias) between the bladder temperature and the other three methods were: left tympanic, 0.65°C (95% CI: −0.24 to 1.58); right tympanic, 0.57°C (95% CI: −0.48 to 1.63) and right axillary, 0.55°C (95% CI: −0.27 to 1.36). Conclusions: The axilla and tympanic membrane are unreliable sites for core body temperature measurement early after cardiopulmonary bypass in adult patients and clinical decisions should be based on more reliable methods.

Keywords

BODY TEMPERATURE, axillary, tympanic, bladderCARDIOPULMONARY BYPASSCATHETERIZATIONSWAN GANZANAESTHESIA RECOVERY PERIODCRITICAL CARE
Type
EACTA Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 7 , July 2006 , pp. 551 - 554
Copyright
© 2006 European Society of Anaesthesiology

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References

Insler SR, O'Coonor MS, Leventhal MJ, Nelson DR, Starr JS. Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery. Ann Thorac Surg 2000; 70: 175–181.Google Scholar
Grocott HP, Mackensen GB, Grigore AM et al. Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery. Stroke 2002; 33: 537–541.Google Scholar
Patel C, Laboy V, Venus B, Mathru M, Wier D. Acute complications of pulmonary artery catheter insertion in critically ill patients. Crit Care Med 1986; 14: 195–197.Google Scholar
Maxton FJ, Justin L, Gillies D. Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. J Adv Nurs 2004; 45: 214–222.Google Scholar
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.Google Scholar
Giuliano KK, Scott SS, Elliot S, Giuliano AJ. Temperature measurement in critically ill orally intubated adults: a comparison of pulmonary artery core, tympanic, and oral methods. Crit Care Med 1999; 27: 2188–2193.Google Scholar
Nierman DM. Core temperature measurement in the intensive care unit. Crit Care Med 1991; 19: 818–823.Google Scholar
Lefrant JY, Muller L, Coussaye JE et al. Temperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method. Intens Care Med 2003; 29: 414–418.Google Scholar
Amoateng-Adjepong Y, Del Mundo J, Manthous CA. Accuracy of an infrared tympanic thermometer. Chest 1999; 115: 1002–1005.Google Scholar
Childs C, Harrison R, Hodkinson C. Tympanic membrane temperature as a measure of core temperature. Arch Dis Child 1999; 80: 262–266.Google Scholar
Takaki O, Kuro M, Ohnishi Y et al. Does rate of urine flow influence the difference between bladder temperature and nasopharyngeal temperature during cardiac surgery with cardiopulmonary bypass? Masui 1993; 42: 1013–1016.Google Scholar
Bojar RM, Warner KG. Manual of Perioperative Care in Cardiac Surgery, 3rd edn. Massachusetts, USA: Blackwell Publishing Company, 1999: 124.
Savino SJ, Floyd TF, Cheung AT. Cardiac anaesthesia. In: Cohn LH, Edmunds Jr LH, eds. Cardiac Surgery in the Adult. New York, USA: McGraw-Hill, 2003: 256.
Scheffer T, Sanders DB. The neurologic sequelae of cardiopulmonary bypass-induced cerebral hyperthermia and cerebroprotective strategies. J Extra Corp Technol 2003; 35: 317–321.Google Scholar