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Is temporal artery thermometry a useful indicator of core body temperature in patients receiving general anesthesia

Paik, Grace J (2018) Is temporal artery thermometry a useful indicator of core body temperature in patients receiving general anesthesia. Undergraduate Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Anesthetic medications and the cold operating room environment are among the factors that increase the risk of decreased core body temperature in surgical patients, which can put a patient at risk for untoward physiologic responses. Therefore, peripheral thermometry methods, like the temporal artery thermometer, have been questioned as an accurate indicator of core body temperature. To determine the usefulness of the temporal artery thermometer in patients receiving general anesthesia, three specific aims were set. First, the study compared the accuracy of temporal artery temperature (Tat) to esophageal temperature (Tes) in estimating core body temperature in the operating room. Second, Tat’s accuracy was compared with oral temperature (Tor) in the post anesthesia care unit (PACU). Lastly, this study determined factors that were associated with the level of agreement between Tes and Tat from the beginning of anesthesia administration (induction time point) to the time the patient is awakened from anesthesia (emergence time point).

A prospective repeated measures design was used at three time points (induction, emergence, and in the post-anesthesia care unit (PACU). Temperatures were collected in 54 surgical patients requiring general anesthesia and Tat was compared to Tes intraoperatively and Tor postoperatively. Data analysis included descriptive statistics, t-test comparison of temperatures, and generation of Bland Altman plots to examine the agreement between thermometry methods. Multiple linear regression was also used to identify factors associated with the agreement between methods.

Results showed that Tes and Tor were all found to be statistically significant for being lower compared to Tat at all three time points. The temporal artery thermometer results produced overestimation of core body temperature paralleled with a poor ability to detect hypothermia. Additionally, the use of muscle relaxants and the location of the surgical site incision (torso compared to neck) were associated with the difference between Tat and Tes from induction to emergence. Therefore, although Tat is more convenient than other thermometry methods, the temporal artery thermometer should be substituted with better indicators of core body temperature to avoid risks of perioperative hypothermia, which is defined as a body temperature less than 36˚C.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Paik, Grace JGJP12@pitt.edu
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairAlexander, Sheilasalexand@pitt.edu
Committee MemberHenker, Richardrhe001@pitt.edu
Committee MemberSereika, Susanssereika@pitt.edu
Committee MemberPiotrowski, Kathleenfallscrn@email.arizona.edu
Date: 23 April 2018
Date Type: Publication
Defense Date: 22 March 2018
Approval Date: 23 April 2018
Submission Date: 11 April 2018
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 39
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
University Honors College
Degree: BSN - Bachelor of Science in Nursing
Thesis Type: Undergraduate Thesis
Refereed: Yes
Uncontrolled Keywords: temperature, thermometry, anesthesia, temporal artery, esophageal, oral
Date Deposited: 23 Apr 2018 19:47
Last Modified: 23 Apr 2018 19:47
URI: http://d-scholarship.pitt.edu/id/eprint/34256

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