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Core-peripheral temperature gradient in children: does it reflect clinically important changes in circulatory
I A Murdoch1, S A Qureshi, A Mitchell
1Department of Paediatric Cardiology, Guy's Hospital, London, UK.
Insights
Core-peripheral temperature gradients in children after open heart surgery can indicate changes in intravascular volume. Monitoring these temperature changes provides valuable insights into a patient
Area of Science:
- Pediatric Cardiac Surgery
- Physiological Monitoring
- Hemodynamic Assessment
Background:
- Post-open heart surgery, accurate assessment of a child's hemodynamic status is crucial.
- Core-peripheral temperature gradients are influenced by circulatory function.
- Understanding these gradients can aid in managing fluid balance.
Purpose of the Study:
- To investigate the relationship between core-peripheral skin temperature changes and hemodynamic parameters in children post-open heart surgery.
- To determine if temperature gradients correlate with cardiac index, systemic vascular resistance, mean arterial pressure, or urinary output.
- To assess the utility of core-peripheral temperature gradients as an indicator of intravascular volume status.
Main Methods:
- Measurements of core and peripheral skin temperatures were taken in 10 children over 1-hour intervals post-surgery.
- Hemodynamic parameters including cardiac index, systemic vascular resistance index, mean arterial pressure, and urinary output were recorded.
- Spearman's rank correlation was used to analyze the relationship between temperature gradients and hemodynamic variables.
Main Results:
- No significant correlations were found between changes in core-peripheral temperature gradient and cardiac index, systemic vascular resistance index, mean arterial pressure, or urinary output.
- A significant correlation was identified between changes in central venous pressure and the core-peripheral temperature gradient.
Conclusions:
- Changes in the core-peripheral temperature gradient after open heart surgery in children correlate with central venous pressure.
- The core-peripheral temperature gradient may serve as a valuable, non-invasive indicator of a patient's intravascular volume status.
- Further research can explore the clinical application of temperature monitoring for fluid management in pediatric cardiac patients.
Abstract:
Following open heart surgery, changes in core and peripheral skin temperature and changes in the core-peripheral temperature gradient were measured in 10 children. These were correlated with changes in cardiac index, systemic vascular resistance index, mean arterial pressure and urinary output. During the study intervals, which lasted 1 h each, no changes in medical management were made. Using Spearman's rank correlation, only a change in central venous pressure was found to correlate with a change in the core-peripheral temperature gradient. We conclude that a change in the core-peripheral temperature will give valuable information about the patient's intravascular volume.