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Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study

PURPOSE: Temperature monitoring in the perioperative setting often represents a compromise between accuracy, invasiveness of probe placement, and patient comfort. Transcutaneous sensors using the Zero-Heat-Flux (ZHF) and Double-Sensor (DS) technology have been developed and evaluated in a variety of...

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Autores principales: Engelbart, Georg, Brandt, Sebastian, Scheeren, Tobias, Tzabazis, Alexander, Kimberger, Oliver, Kellner, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651547/
https://www.ncbi.nlm.nih.gov/pubmed/37436599
http://dx.doi.org/10.1007/s10877-023-01049-7
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author Engelbart, Georg
Brandt, Sebastian
Scheeren, Tobias
Tzabazis, Alexander
Kimberger, Oliver
Kellner, Patrick
author_facet Engelbart, Georg
Brandt, Sebastian
Scheeren, Tobias
Tzabazis, Alexander
Kimberger, Oliver
Kellner, Patrick
author_sort Engelbart, Georg
collection PubMed
description PURPOSE: Temperature monitoring in the perioperative setting often represents a compromise between accuracy, invasiveness of probe placement, and patient comfort. Transcutaneous sensors using the Zero-Heat-Flux (ZHF) and Double-Sensor (DS) technology have been developed and evaluated in a variety of clinical settings. The present study is the first to compare the performance of both sensors simultaneously with temperature measured by a Swan-Ganz catheter (PAC) in patients admitted to the intensive care unit (ICU) after cardiac surgery. METHODS: In this monocentric prospective observational study patients were postoperatively transferred to the ICU and both sensors were placed on the patients’ foreheads. Core body temperature measured by intraoperatively placed PAC served as gold standard. Measurements were recorded at 5-minute intervals and up to 40 data sets per patient were recorded. Bland and Altman’s method for repeated measurements was used to analyse agreement. Subgroup analyses for gender, body-mass-index, core temperature, airway status and different time intervals were performed. Lin’s concordance correlation coefficient (LCCC) was calculated, as well as sensitivity and specificity for detecting hyperthermia (≥ 38 °C) and hypothermia (< 36 °C). RESULTS: Over a period of six month, we collected 1600 sets of DS, ZHF, and PAC measurements, from a total of 40 patients. Bland-Altman analysis revealed a mean bias of -0.82 ± 1.27 °C (average ± 95% Limits-of-Agreement (LoA)) and − 0.54 ± 1.14 °C for DS and ZHF, respectively. The LCCC was 0.5 (DS) and 0.63 (ZHF). Mean bias was significantly higher in hyperthermic and hypothermic patients. Sensitivity and specificity were 0.12 / 0.99 (DS) and 0.35 / 1.0 (ZHF) for hyperthermia and 0.95 / 0.72 (DS) and 1.0 / 0.85 (ZHF) for hypothermia. CONCLUSION: Core temperature was generally underestimated by the non-invasive approaches. In our study, ZHF outperformed DS. In terms of agreement, results for both sensors were outside the range that is considered clinically acceptable. Nevertheless, both sensors might be adequate to detect postoperative hypothermia reliably when more invasive methods are not available or appropriate. TRIAL REGISTRATION: German Register of Clinical Trials (DRKS-ID: DRKS00027003), retrospectively registered 10/28/2021. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-023-01049-7.
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spelling pubmed-106515472023-07-12 Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study Engelbart, Georg Brandt, Sebastian Scheeren, Tobias Tzabazis, Alexander Kimberger, Oliver Kellner, Patrick J Clin Monit Comput Original Research PURPOSE: Temperature monitoring in the perioperative setting often represents a compromise between accuracy, invasiveness of probe placement, and patient comfort. Transcutaneous sensors using the Zero-Heat-Flux (ZHF) and Double-Sensor (DS) technology have been developed and evaluated in a variety of clinical settings. The present study is the first to compare the performance of both sensors simultaneously with temperature measured by a Swan-Ganz catheter (PAC) in patients admitted to the intensive care unit (ICU) after cardiac surgery. METHODS: In this monocentric prospective observational study patients were postoperatively transferred to the ICU and both sensors were placed on the patients’ foreheads. Core body temperature measured by intraoperatively placed PAC served as gold standard. Measurements were recorded at 5-minute intervals and up to 40 data sets per patient were recorded. Bland and Altman’s method for repeated measurements was used to analyse agreement. Subgroup analyses for gender, body-mass-index, core temperature, airway status and different time intervals were performed. Lin’s concordance correlation coefficient (LCCC) was calculated, as well as sensitivity and specificity for detecting hyperthermia (≥ 38 °C) and hypothermia (< 36 °C). RESULTS: Over a period of six month, we collected 1600 sets of DS, ZHF, and PAC measurements, from a total of 40 patients. Bland-Altman analysis revealed a mean bias of -0.82 ± 1.27 °C (average ± 95% Limits-of-Agreement (LoA)) and − 0.54 ± 1.14 °C for DS and ZHF, respectively. The LCCC was 0.5 (DS) and 0.63 (ZHF). Mean bias was significantly higher in hyperthermic and hypothermic patients. Sensitivity and specificity were 0.12 / 0.99 (DS) and 0.35 / 1.0 (ZHF) for hyperthermia and 0.95 / 0.72 (DS) and 1.0 / 0.85 (ZHF) for hypothermia. CONCLUSION: Core temperature was generally underestimated by the non-invasive approaches. In our study, ZHF outperformed DS. In terms of agreement, results for both sensors were outside the range that is considered clinically acceptable. Nevertheless, both sensors might be adequate to detect postoperative hypothermia reliably when more invasive methods are not available or appropriate. TRIAL REGISTRATION: German Register of Clinical Trials (DRKS-ID: DRKS00027003), retrospectively registered 10/28/2021. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10877-023-01049-7. Springer Netherlands 2023-07-12 2023 /pmc/articles/PMC10651547/ /pubmed/37436599 http://dx.doi.org/10.1007/s10877-023-01049-7 Text en © The Author(s) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Research
Engelbart, Georg
Brandt, Sebastian
Scheeren, Tobias
Tzabazis, Alexander
Kimberger, Oliver
Kellner, Patrick
Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title_full Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title_fullStr Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title_full_unstemmed Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title_short Accuracy of non-invasive sensors measuring core body temperature in cardiac surgery ICU patients – results from a monocentric prospective observational study
title_sort accuracy of non-invasive sensors measuring core body temperature in cardiac surgery icu patients – results from a monocentric prospective observational study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651547/
https://www.ncbi.nlm.nih.gov/pubmed/37436599
http://dx.doi.org/10.1007/s10877-023-01049-7
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