Core-peripheral temperature gradient does not predict cardiac output or systemic vascular resistance in children

Area of Science:

• Pediatric Cardiac Surgery
• Cardiovascular Physiology
• Hemodynamic Monitoring

Background:

• Phenoxybenzamine is used post-cardiac surgery.
• Cardiopulmonary bypass can affect hemodynamics.
• Monitoring cardiac output and vascular resistance is crucial in pediatric cardiac surgery.

Purpose of the Study:

• To investigate the correlation between temperature gradients and hemodynamic parameters in children after cardiac surgery.
• To determine if peripheral and core-peripheral temperature differences can guide cardiac output or systemic vascular resistance measurements.

Main Methods:

• Prospective measurement of toe temperature, rectal temperature, systemic arterial pressure, and cardiac output.
• Measurements were taken twice, one hour apart, in 136 children.
• Repeated measures analysis was used to assess correlations.

Main Results:

• No significant correlation was found between the change in temperature gradient over one hour and the change in cardiac index (r = 0.03, P > 0.1).
• No significant correlation was observed between the change in temperature gradient and the change in systemic vascular resistance (r = 0.007, P > 0.1).
• Peripheral (toe) temperature and core-peripheral temperature difference did not correlate with cardiac output or systemic vascular resistance.

Conclusions:

• Simple, safe, and inexpensive temperature measurements (toe and core-peripheral difference) are not reliable indicators for guiding cardiac output or systemic vascular resistance in children post-cardiac surgery on cardiopulmonary bypass.
• These temperature metrics do not serve as effective surrogates for hemodynamic monitoring in this specific pediatric population.