Site of temperature monitoring and prediction of afterdrop after open heart surgery

Ramsay, James G.; Ralley, Fiona E.; Whalley, David G.; DelliColli, P; Wynands, J. Earl

doi:10.1007/bf03011406

Cited by 50 publications

(24 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rectal temperature correlates well in most patients with distal esophageal, bladder, and tympanic temperatures [12,13]. Due to thermal inertia in the rectum, it is typically the slowest of the central measurement sites to respond to induced changes in temperature [14,15].…”

Section: Temperature Monitoringmentioning

confidence: 99%

“…Urinary bladder temperature can be easily measured with a specially designed temperature probe embedded in a Foley catheter [12][13][14][15]. In patients undergoing induced hypothermia and rewarming, bladder temperatures correlate well with great vessel and rectal temperatures and less well with esophageal temperatures [13][14][15].…”

Section: Temperature Monitoringmentioning

confidence: 99%

See 1 more Smart Citation

Routine Monitoring of Critically I11 Patients

Curley

Smyrnios

1990

J Intensive Care Med

View full text Add to dashboard Cite

The explosion in computer use and technology during the past several decades has dramatically changed criti cal care. All vital signs can now be monitored accu rately, noninvasively, and continuously. We examined the predominantly noninvasive methods of monitor ing temperature, arterial blood pressure, heart rate and rhythm, respiratory mechanics, and gas exchange that can be used continuously on almost every patient in the intensive care unit. We conclude that temperature should be measured either intermittently with a rectal thermometer or continuously with a rectal, bladder, or great vessel thermocouple or thermistor probe. Arterial pressure should be measured either intermittently with a sphygmomanometer and cuff or continuously with an indwelling arterial catheter, except in specific situa tions when automated indirect monitoring may be use ful. Electrocardiographic rhythm monitoring has been clearly shown to improve prognosis in patients after acute myocardial infarction and should be universal in all intensive care units. Ischemia monitoring may prove beneficial, but its role has not been clearly defined. Re spiratory inductance plethysmography is effective in measuring respiratory rate, tidal volume, and breathing pattern. Pulse oximetry is useful in detecting occult hy poxemia. It should be continuous on most patients. Transcutaneous oxygen and carbon dioxide measure ment has a limited role in monitoring gas exchange and perfusion. Capnography also has a limited role in the intensive care unit but is more helpful in the operating room.

show abstract

Section: Temperature Monitoringmentioning

confidence: 99%

Section: Temperature Monitoringmentioning

confidence: 99%

Routine Monitoring of Critically I11 Patients

Curley

Smyrnios

1990

J Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…However, each of these sites has unique problems [3], and none of them may reflect brain temperature reliably throughout the CPB [4]. In addition to core temperature monitoring, temperature monitoring at intermediate or peripheral zones (e.g., rectum, urinary bladder, muscle, skin) has been recommended to assess adequate whole body rewarming during CPB [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction

Akata

Yamaura

Kimura

et al. 2004

Journal of Anesthesia

View full text Add to dashboard Cite

show abstract

“…Corp. Helsinki, Finland) placed in the nasopharynx and in the rectum; nasopharyngeal and rectal temperatures indicated the temperature of the body core and muscular compartments. 8 All probes were accurate to Ϯ 0.1 ЊC over the range 20-40 ЊC.…”

mentioning

confidence: 99%

Benefits of intraoperative skin surface warming in cardiac surgical patients

Hohn

Schweizer

Kalangos

et al. 1998

British Journal of Anaesthesia

View full text Add to dashboard Cite

SummaryWe have investigated patients undergoing cardiac surgery with hypothermic bypass to see if the addition of skin surface warming during systemic rewarming on bypass (heated group, n : 43) would improve perioperative thermal balance compared with conventional management without skin warming (control group, n : 43) in an open, randomized, controlled study. Intraoperative skin warming with a water mattress and forced warm air over the face, neck and shoulders attenuated the afterdrop in nasopharyngeal temperature after weaning from bypass (2.3 (1.2) ЊC and 1.3 (0.5) ЊC in the control and heated groups, respectively) (P : 0.05) and resulted in higher rectal temperature 4 h after surgery. Despite similar standard coagulation tests, heated patients had lower blood loss via the chest tubes (600 (264) ml vs 956 (448) ml in control patients) (P : 0.05). and less requirements for i.v. colloid infusion (1662 (404) ml vs 1994 (389) ml) (P : 0.05). There was a significant inverse correlation between rectal temperature on arrival in the ICU and postoperative blood loss (r : 0.57, P : 0.001). These data suggest that additional skin surface warming with a water mattress and forced warm air helped to preserve perioperative thermal balance and may contribute to reduced bleeding after cardiac surgery. (Br. J. Anaesth. 1998; 80: 318-323) Keywords: temperature, body; equipment, warming devices; surgery, cardiovascular; blood, coagulation; hypothermia Hypothermia remains a common problem because of its deleterious haemodynamic, haemostatic, immune and metabolic effects.1-4 After non-cardiac surgery, mild hypothermia has also been associated with arterial hypertension and myocardial ischaemia, 5 in addition to increased blood loss. 6 Patients undergoing cardiac surgery are often cooled to nasopharyngeal temperatures of 26-28 ЊC. At the end of cardiopulmonary bypass (CPB), even though nasopharyngeal temperature is restored to pre-bypass levels, a considerable mass of peripheral tissues remains at subnormal temperatures; subsequent redistribution of heat from the core to the periphery causes a decrease in nasopharyngeal temperature ranging from 1 to 3 ЊC, termed "afterdrop".7 8 During operation, adopting a "normothermic" bypass technique, prolonging the rewarming period or infusing vasodilators while increasing pump flow may attenuate the postoperative central temperature afterdrop. 9 In the intensive care unit (ICU), external heat, that is convective or radiant, applied over a large body surface area has been shown to accelerate rewarming with the benefits of less shivering, lower oxygen demand and more haemodynamic stability. [10][11][12][13] Although skin surface warming with a forced warm air device is a simple, safe and efficient means for preventing hypothermia during major surgical procedures, 14 it has not yet been recommended for use during cardiac surgery because the body surface area available for cutaneous warming was thought to be too small.As the afterdrop in nasopharyngeal temperature is attributed to redistribut...

show abstract

Site of temperature monitoring and prediction of afterdrop after open heart surgery

Cited by 50 publications

References 6 publications

Routine Monitoring of Critically I11 Patients

Routine Monitoring of Critically I11 Patients

Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction

Benefits of intraoperative skin surface warming in cardiac surgical patients

Contact Info

Product

Resources

About