Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index
Assessment of peripheral perfusion and comparison of surface and body core temperature (BST; BCT) are diagnostic cornerstones of critical care. Infrared non-contact thermometers facilitate the accurate measurement of BST. Additionally, a corrected measurement of BST on the forehead provides an estim...
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AIMS Press
2020-01-01
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| Series: | Mathematical Biosciences and Engineering |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/mbe.2020059?viewType=HTML |
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| author | Wolfgang Huber Claudia Wiedemann Tobias Lahmer Joseph Hoellthaler Henrik Einwächter Matthias Treiber Christoph Schlag Roland Schmid Markus Heilmaier |
| author_facet | Wolfgang Huber Claudia Wiedemann Tobias Lahmer Joseph Hoellthaler Henrik Einwächter Matthias Treiber Christoph Schlag Roland Schmid Markus Heilmaier |
| author_sort | Wolfgang Huber |
| collection | DOAJ |
| description | Assessment of peripheral perfusion and comparison of surface and body core temperature (BST; BCT) are diagnostic cornerstones of critical care. Infrared non-contact thermometers facilitate the accurate measurement of BST. Additionally, a corrected measurement of BST on the forehead provides an estimate of BCT (BCT_Forehead). In clinical routine BCT is measured by ear thermometers (BCT_Ear). The PiCCO-device (PiCCO: Pulse contour analysis) provides thermodilution-derived Cardiac Index (CI_TD) using an arterial catheter with a thermistor tip in the distal aorta. Therefore, the PiCCO-catheter might be used for <i>continuous</i> BCT-measurement (BCT_PiCCO) in addition to <i>intermittent</i> CI-measurement. To the best of our knowledge, BCT_PiCCO has not been validated compared to standard techniques of BCT-measurement including measurement of urinary bladder temperature (BCT_Bladder). Therefore, we compared BCT_PiCCO to BCT_Ear and BCT_Bladder in 52 patients equipped with the PiCCO-device (Pulsion; Germany). Furthermore, this setting allowed to compare different BSTs and their differences to BCT with CI_TD. BCT_PiCCO, BCT_Ear (ThermoScan; Braun), BCT_Bladder (UROSID; ASID BONZ), BCT_Forehead and BSTs (Thermofocus; Tecnimed) were measured four times within 24h. BSTs were determined on the great toe, finger pad and forearm. Immediately afterwards TPTD was performed to obtain CI_TD. 32 (62%) male, 20 (38%) female patients; APACHE-II 23.8 ±8.3. Bland-Altman-analysis demonstrated low bias and percentage error (PE) values for the comparisons of BCT_PiCCO vs. BCT_Bladder (bias 0.05 ±0.27° Celsius; PE = 1.4%), BCT_PiCCO vs. BCT_Ear (bias 0.08 ±0.38° Celsius; PE = 2.0%) and BCT_Ear vs. BCT_Bladder (bias 0.04 ±0.42° Celsius; PE = 2.2). While BCT_PiCCO, BCT_Ear and BCT_Bladder can be considered interchangeable, Bland-Altman-analyses of BCT_Forehead vs. BCT_PiCCO (bias = -0.63 ±0.75° Celsius; PE = 3.9%) Celsisus, BCT_Ear (bias = -0.58 ±0.68° Celsius; PE = 3.6%) and BCT_Bladder (bias = -0.55 ±0.74° Celsius; PE = 3.9%) demonstrate a substantial underestimation of BCT by BCT_Forehead. BSTs and differences between BCT and BST (DCST) significantly correlated with CI_TD with r-values between 0.230 and 0.307 and p-values between 0.002 and p < 0.001. The strongest association with CI_TD was found for BST_forearm (r = 0.307; p < 0.001). In a multivariate analysis regarding CI_TD and including biometric data, BSTs and and their differences to core-temperatures (DCST), only higher temperatures on the forearm and the great toe, young age, low height and male gender were independently associated with CI_TD. The estimate of CI based on this model (CI_estimated) correlated with CI_TD (r = 0.594; p < 0.001). CI_estimated provided large ROC-areas under the curve (AUC) regarding the critical thresholds of CI_TD ≤ 2.5 L/min/m<sup>2</sup> (AUC = 0.862) and CI_TD ≥ 5.0 L/min/m<sup>2</sup> (AUC = 0.782). 1.) BCT_PiCCO, BCT_Ear and BCT_Bladder are interchangeable. 2.) BCT_Forehead significantly underestimates BCT by about 0.5° Celsius. 3.) All measured BSTs and DCSTs were significantly associated with CI_TD. 4.) CI_estimated is promising, in particular for the prediction of critical thresholds of CI. |
| first_indexed | 2024-12-14T02:41:07Z |
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| id | doaj.art-e348e399a6ff456b843e4347cb2acd0d |
| institution | Directory Open Access Journal |
| issn | 1551-0018 |
| language | English |
| last_indexed | 2024-12-14T02:41:07Z |
| publishDate | 2020-01-01 |
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| series | Mathematical Biosciences and Engineering |
| spelling | doaj.art-e348e399a6ff456b843e4347cb2acd0d2022-12-21T23:20:01ZengAIMS PressMathematical Biosciences and Engineering1551-00182020-01-011721132114610.3934/mbe.2020059Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac IndexWolfgang Huber0Claudia Wiedemann1Tobias Lahmer 2Joseph Hoellthaler3Henrik Einwächter4Matthias Treiber5Christoph Schlag6Roland Schmid 7Markus Heilmaier8Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyMedizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, D-81675 München, GermanyAssessment of peripheral perfusion and comparison of surface and body core temperature (BST; BCT) are diagnostic cornerstones of critical care. Infrared non-contact thermometers facilitate the accurate measurement of BST. Additionally, a corrected measurement of BST on the forehead provides an estimate of BCT (BCT_Forehead). In clinical routine BCT is measured by ear thermometers (BCT_Ear). The PiCCO-device (PiCCO: Pulse contour analysis) provides thermodilution-derived Cardiac Index (CI_TD) using an arterial catheter with a thermistor tip in the distal aorta. Therefore, the PiCCO-catheter might be used for <i>continuous</i> BCT-measurement (BCT_PiCCO) in addition to <i>intermittent</i> CI-measurement. To the best of our knowledge, BCT_PiCCO has not been validated compared to standard techniques of BCT-measurement including measurement of urinary bladder temperature (BCT_Bladder). Therefore, we compared BCT_PiCCO to BCT_Ear and BCT_Bladder in 52 patients equipped with the PiCCO-device (Pulsion; Germany). Furthermore, this setting allowed to compare different BSTs and their differences to BCT with CI_TD. BCT_PiCCO, BCT_Ear (ThermoScan; Braun), BCT_Bladder (UROSID; ASID BONZ), BCT_Forehead and BSTs (Thermofocus; Tecnimed) were measured four times within 24h. BSTs were determined on the great toe, finger pad and forearm. Immediately afterwards TPTD was performed to obtain CI_TD. 32 (62%) male, 20 (38%) female patients; APACHE-II 23.8 ±8.3. Bland-Altman-analysis demonstrated low bias and percentage error (PE) values for the comparisons of BCT_PiCCO vs. BCT_Bladder (bias 0.05 ±0.27° Celsius; PE = 1.4%), BCT_PiCCO vs. BCT_Ear (bias 0.08 ±0.38° Celsius; PE = 2.0%) and BCT_Ear vs. BCT_Bladder (bias 0.04 ±0.42° Celsius; PE = 2.2). While BCT_PiCCO, BCT_Ear and BCT_Bladder can be considered interchangeable, Bland-Altman-analyses of BCT_Forehead vs. BCT_PiCCO (bias = -0.63 ±0.75° Celsius; PE = 3.9%) Celsisus, BCT_Ear (bias = -0.58 ±0.68° Celsius; PE = 3.6%) and BCT_Bladder (bias = -0.55 ±0.74° Celsius; PE = 3.9%) demonstrate a substantial underestimation of BCT by BCT_Forehead. BSTs and differences between BCT and BST (DCST) significantly correlated with CI_TD with r-values between 0.230 and 0.307 and p-values between 0.002 and p < 0.001. The strongest association with CI_TD was found for BST_forearm (r = 0.307; p < 0.001). In a multivariate analysis regarding CI_TD and including biometric data, BSTs and and their differences to core-temperatures (DCST), only higher temperatures on the forearm and the great toe, young age, low height and male gender were independently associated with CI_TD. The estimate of CI based on this model (CI_estimated) correlated with CI_TD (r = 0.594; p < 0.001). CI_estimated provided large ROC-areas under the curve (AUC) regarding the critical thresholds of CI_TD ≤ 2.5 L/min/m<sup>2</sup> (AUC = 0.862) and CI_TD ≥ 5.0 L/min/m<sup>2</sup> (AUC = 0.782). 1.) BCT_PiCCO, BCT_Ear and BCT_Bladder are interchangeable. 2.) BCT_Forehead significantly underestimates BCT by about 0.5° Celsius. 3.) All measured BSTs and DCSTs were significantly associated with CI_TD. 4.) CI_estimated is promising, in particular for the prediction of critical thresholds of CI.https://www.aimspress.com/article/doi/10.3934/mbe.2020059?viewType=HTMLbody core temperaturebody surface temperaturetoe temperatureinfrared thermometercardiac indextranspulmonary thermodilutionpiccourinary bladder thermistorthermofocus |
| spellingShingle | Wolfgang Huber Claudia Wiedemann Tobias Lahmer Joseph Hoellthaler Henrik Einwächter Matthias Treiber Christoph Schlag Roland Schmid Markus Heilmaier Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index Mathematical Biosciences and Engineering body core temperature body surface temperature toe temperature infrared thermometer cardiac index transpulmonary thermodilution picco urinary bladder thermistor thermofocus |
| title | Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index |
| title_full | Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index |
| title_fullStr | Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index |
| title_full_unstemmed | Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index |
| title_short | Body surface and body core temperatures and their associations to haemodynamics: The BOSTON-I-study: Validation of a thermodilution catheter (PiCCO) to measure body core temperature and comparison of body surface temperatures to thermodilutionderived Cardiac Index |
| title_sort | body surface and body core temperatures and their associations to haemodynamics the boston i study validation of a thermodilution catheter picco to measure body core temperature and comparison of body surface temperatures to thermodilutionderived cardiac index |
| topic | body core temperature body surface temperature toe temperature infrared thermometer cardiac index transpulmonary thermodilution picco urinary bladder thermistor thermofocus |
| url | https://www.aimspress.com/article/doi/10.3934/mbe.2020059?viewType=HTML |
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