Elsevier

Resuscitation

Volume 83, Issue 2, February 2012, Pages 208-212
Resuscitation

Clinical paper
Relationship between blood, nasopharyngeal and urinary bladder temperature during intravascular cooling for therapeutic hypothermia after cardiac arrest

https://doi.org/10.1016/j.resuscitation.2011.09.001Get rights and content

Abstract

Objectives

Therapeutic hypothermia improves survival and neurological outcome in patients successfully resuscitated after cardiac arrest. Accurate temperature control during cooling is essential to prevent cooling-related side effects.

Methods

Prospective observational study of 12 patients assessed during therapeutic hypothermia (32–34 °C) achieved by intravascular cooling following cardiac arrest. Simultaneous temperature measurements were taken using a Swan–Ganz catheter (blood temperature BLT), nasopharyngeal probe (nasopharyngeal temperature NPT) and the urinary bladder catheter (urinary bladder temperature UBT). A total of 1728 measurements (144 measurements per patient) were recorded over a 48-h period and analyzed. Blood temperature was considered as the reference measurement.

Results

Temperature profiles obtained from BLT, NPT and UBT compared with the use of analysis of variance did not differ significantly. Pearson correlation revealed that the correlation between BLT and NPT as well as BLT and UBT was statistically significant (r = 0.96, p < 0.001 and r = 0.95, p < 0.001, respectively). Bland–Altman analysis proved that the agreement between all measurements was satisfactory and the differences were not clinically important.

Conclusions

In 12 post-cardiac arrest patients undergoing intravascular cooling, both nasopharyngeal and urinary bladder temperature measurements were similar to blood temperatures measured using a pulmonary artery catheter.

Section snippets

Methods

This prospective observational study was performed in 12 patients during therapeutic hypothermia following successful resuscitation from cardiac arrest. The study was approved by the Ethics Committee of the Medical University of Silesia and the need for an informed consent was waived. Study exclusions were age less than 18 years or more than 75 years, initial blood temperature less than 35 °C, and the inability to achieve a blood temperature less than 34 °C after 12 h of cooling. All patients were

Results

Patient demographics are shown in Table 1. Patients were recruited between June 2007 and March 2010. Initially, there were 14 patients recruited, but we excluded two patients due to inability to achieve a blood temperature of less than 34 °C after 12 h of cooling.

The mean time to achieve a temperature of less than 34 °C was 4.2 ± 3.6 h (range 1–13 h). A stable temperature profile during hypothermia (maintenance of a BLT in a range of 32–34 °C during the whole final 12 h of the cooling period) was

Discussion

Body temperature of ICU patients can be monitored with a variety of devices and at a variety of body sites.8, 9, 10, 11 During hypothermia we are mainly interested in a core temperature and therefore a most reliable site for temperature management would be either pulmonary artery or jugular venous bulb.10, 12 In practice, measurements of core temperature are performed also in the oesophagus, nasopharyngeal cavity, urinary bladder, rectum or the external auditory canal near the tympanic membrane.

Conclusion

In 12 post-cardiac arrest patients undergoing intravascular cooling, both nasopharyngeal and urinary bladder temperature measurements were similar to blood temperatures measured using a pulmonary artery catheter.

Conflict of interest statement

We do not have any conflict of interest regarding this study.

Acknowledgements

We wish to thank the students of our Scientific Circle: Anna Konopka, Paweł Chodór, Tomasz Pawlas, Maciej Pełka, Sławomir Pakuło, Łukasz Kozioł and Paweł Kraus for their enormous help in collecting the data for this study. We also would like to thank Mrs Jolanta Cieśla for her help in preparing the manuscript. The study was supported by the governmental research grant 2 P05C 066 30.

References (17)

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A Spanish translated version of the summary of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2011.09.001.

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