在重症患者中非侵入性体温测量方法的准确性:一个前性的,双中心的,观察性研究
Salvatore L Cutuli1,2, Eduardo A Osawa1, Christopher T Eyeington1
1Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
概括
非侵入性体温方法,如股化学点,耳红外和部扫描仪,对于重症监护室 (ICU) 患者来说不准确. 这些设备显示出与核心温度的显著偏差,使得它们无法用于重症监测.
科学领域:
- 关键护理医学 关键护理医学
- 生物医学工程 生物医学工程
- 临床测热仪临床测热仪
背景情况:
- 精确的核心体温监测对于重症病患在重症监护室 (ICU) 中至关重要.
- 非侵入性温度测量方法被广泛使用,但它们在ICU环境中的准确性仍然不确定.
研究的目的:
- 评估三种常见的非侵入性体温测量方法与ICU患者的侵入性核心温度测量的准确性.
- 确定非侵入性方法是否符合临床充分性标准 (1°C的协议限制).
主要方法:
- 在澳大利亚两所三级重症监护室进行的前性观察研究.
- 在重症患者中比较了侵入性 (血管内,尿液膀导管) 和非侵入性 (尾化学点,耳红外线,部扫描仪) 温度测量.
- 使用布兰德-阿尔特曼分析进行准确性评估,对重复测量进行核算,以及对解释变量的回归分析.
主要成果:
- 在72小时内,研究了50名危急病患者,主要是心脏手术后的患者.
- 侵入性和非侵入性方法之间的平均一致度大约为3°C.
- 时间扫描仪,鼓膜红外线和腹化学点方法显示出显著的偏差和广泛的一致性,未能达到临床充分性.
结论:
- 轴心化学点, tympanic 红外线和时间扫描仪方法对于测量ICU患者的核心体温是不准确的.
- 这些非侵入性温度监测技术在重症监护机构的临床决策中不可靠.
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