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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Postoperative Phase ; Ösophagustemperatur ; Blasentemperatur ; Rektaltemperatur ; Vergleich verschiedener Meßorte ; Key words Postoperative period ; Oesophageal temperature ; Bladder temperature ; Rectal temperature ; Comparison of different sites of measurement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Objective: The data of 60 postoperatively sedated and ventilated patients were studied for analysis of oesophageal, bladder, and rectal temperatures. The purpose of the investigation was to clarify whether changes of oesophageal temperature are adequately reflected by bladder and rectal temperatures and whether the rate of rewarming has an influence on the accuracy of the latter two sites. Methods: For temperature recording, a Hi-Lo Temp® esophageal stethoscope (Mallinckrodt Medical), a Foley FC400-18 catheter temperature sensor (Respiratory Support Products, Mallinckrodt Medical), and a rectal temperature probe N401 (YSI) were used. Each probe and matching recording unit was calibrated over a range of 30–40 °C against a reference quartz thermometer (Hewlett packard Model 2801 A) in a thermostated water bath before the investigation. Five measuring points distributed over the whole period of rewarming were evaluated. Patients were assigned to groups with slow and fast rewarming, respectively. Agreement between the methods of measurement was assessed as described by Bland and Altman. Furthermore, differences between the oesophageal and bladder or rectal temperature were checked at each measuring point for statistical significance using the t-test. Results: In regard to oesophageal temperature, the bladder and rectal temperatures had biases of –0.01 °C and –0.03 °C, respectively. Limits of agreement (±2 s) were ±0.68 °C and ±0.82 °C, respectively. The bias of the bladder temperature was independent of the rate of rewarming (Fig. 3). The bias of the rectal temperature, however, differed in regard to the rewarming rate, being +0.06 °C in the group with slow rewarming and –0.13 °C in the group with fast rewarming (Tables 1 and 2, Fig. 1 and 2). These differences were significant for the measuring points 4 and 5 (Fig. 4). Conclusions: Bladder and rectal temperatures can accurately indicate the oesophageal temperature with a very small bias in postoperatively sedated and ventilated patients. Since the rate of rewarming influences the accuracy of rectal temperature readings, monitoring of bladder temperature seems to be more favourable in the postoperative period.
    Notes: Zusammenfassung In einer retrospektiven Untersuchung wurden bei 60 postoperativ nachbeatmeten Patienten während der Phase der Wiedererwärmung die Temperaturen in Ösophagus, Blase und Rektum miteinander verglichen. Ziel der Untersuchung war zu klären, wie gut Blasen- und Rektaltemperatur mit der Ösophagustemperatur übereinstimmten und ob die Wiedererwärmungsgeschwindigkeit einen Einfluß auf die Genauigkeit dieser beiden Meßorte hatte. Material und Methoden: Es wurden fünf Meßpunkte pro Patient berücksichtigt, die zu gleichen Teilen über die Wiedererwärmungsperiode verteilt wurden. Um den Einfluß der Wiedererwärmungsgeschwindigkeit zu erfassen, wurden die Patienten retrospektiv einer Gruppe mit schneller oder langsamer Wiedererwärmung zugeordnet. Ergebnisse: Die Blasentemperatur weist gegenüber der Ösophagustemperatur eine systematische Abweichung von –0,01 °C und eine Meßunsicherheit (±2 s) von ±0,68 °C auf und ist unabhängig von der Wiedererwärmungsgeschwindigkeit. Die Rektaltemperatur zeigt eine systematische Abweichung von –0,03 °C und eine Meßunsicherheit von ±0,82 °C. Die systematische Abweichung der Rektaltemperatur betrug bei langsamer Wiedererwärmung ±0,06 °C, bei schneller Wiedererwärmung hingegen –0,13 °C. Die Unterschiede waren für die Meßpunkte 4 und 5 statistisch signifikant. Schlußfolgerung: Aus diesem Grund scheint die Messung der Blasentemperatur in der postoperativen Phase vorteilhafter zu sein als die Messung der Rektaltemperatur.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0350
    Keywords: Keywords Hydrocephalus ; Intracranial compliance ; Shunt evaluation ; Pressure/flow parameters ; Simulation of intracranial pressure patterns
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Various methods of laboratory testing are currently being used to explore the hydrodynamic properties of shunts. We constructed a novel shunt-testing rig with a human-like compliance to be able to subject shunts to in-vivo recorded ICP patterns. The human-like situation was realized with a pear-shaped glass container with a non-linear, third-order pressure/volume characteristic similar to the CSF system. The new device also allows conventional shunt testing. Shunt performance in conventional pressure/flow tests (linear compliance) was compared to tests with human-like compliance. No clinically relevant differences were seen. Clinically recorded ICP waves (Lundberg type A and B) were reproduced before and after shunt implementation. Shunt insertion reduced pressure in the A-wave pattern to slightly negative values. Reproducing B-waves, the shunt dampened wave amplitude and pressure decreased below the opening pressure of the valve. In conclusion, the presented device allows a standardized reproduction of ICP patterns. The effects of shunt implantation can be studied.
    Type of Medium: Electronic Resource
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