新型无创核心体温监测系统TTP的评价
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Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System
背景与目的
Temple Touch Pro（TTP）是一种新的系统，这个系统可以从皮肤表面的颞动脉测量核心温度。我们要检验这样一个假设：这种无创的系统能够把核心温度的测定精度控制在0.5℃的范围内。
方 法
通过将TTP的传感器贴片固定在一个颞动脉上，在50名成人和小儿外科手术患者中连续监测核心温度。传感器由皮肤表面附近的热敏电阻阵列、绝缘体上方的另一组热敏电阻以及上部单元与环境之间的第二绝缘体组成。传感器测量皮肤温度和热流量，监视器单元用专有算法估计核心温度。从食管或鼻咽测量参考核心温度。我们使用95％Bland-Altman分析法测量数据的一致性，在TTP和参考核心温度测量之间进行一致性分析，估计在0.5ºC以内的所有差异的比例和一致性相关系数（CCC）。
结 果
在成年人和儿科患者中，TTP测量温度和参考核心温度的一致性都较好。 Bland-Altman图在35.2ºC至37.8ºC的温度范围内没有显示系统偏差或变异性。估计95％的上限和下限为-0.57ºC（95％置信区间[CI]，-0.76至-0.41）和0.57ºC（95％CI，0.44至0.71），表明两种方法之间存在很好的一致性。TTP温度的百分之九十四（95％CI，87％至99％）相差参考温度的0.5ºC以内。 重复测量的CCC为0.82（95％CI，0.66至0.91）也支持这种好的结论。 TTP核心温度的测量值也符合鼻咽参考温度。
结 论
无创TTP系统对于常规术中核心温度的监测具有足够的准确性和可靠性。
原始文献摘要
Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System Evron, Shmuel; Weissman, Avi; Toivis, Vadim; More Anesthesia & Analgesia . 125(1):103-109, July 2017
BACKGROUND:
The Temple Touch Pro (TTP) is a novel system that estimates core temperature from skin over the temporal artery. We tested the hypothesis that this noninvasive system esti-mates core temperature to an accuracy within 0.5ºC.
METHODS:
Core temperature was continuously monitored in 50 adult and pediatric surgical patients by positioning the sensor patch of a TTP over one temporal artery. The sensor consists of a thermistor array near the skin surface, another set of thermistors above an insulator, and a second insulator between the upper unit and the environment. The sensor measures skin
temperature and heat flux, from which the monitor unit estimates core temperature from a proprietary algorithm. Reference core temperature was measured from the esophagus or naso-pharynx. We conducted agreement analysis between the TTP and the reference core tempera-ture measurements using the 95% Bland-Altman limits of agreement for repeated measurement data. The proportion of all differences that were within 0.5ºC and repeat measures concordance correlation coefficient (CCC) were estimated as well.
RESULTS:
TTP and the reference core temperature measurements agreed well in both adults and pediatric patients. Bland-Altman plots showed no evidence of systematic bias or variability over the temperature from 35.2ºC to 37.8ºC. The estimated 95% lower and upper limits of agreement were −0.57ºC (95% confidence interval [CI], −0.76 to −0.41) and 0.57ºC (95% CI,0.44 to 0.71), indicating good agreement between the 2 methods. Ninety-four percentage (95% CI, 87% to 99%) of the TTP temperatures were within 0.5ºC of the reference temperature. Good agreement was also supported by an estimated repeated measures CCC of 0.82 (95% CI, 0.66 to 0.91). The TTP core temperature measurements also agreed well with nasopharyngeal refer-ence temperatures.
CONCLUSIONS: The noninvasive TTP system is sufficiently accurate and reliable for routine intraoperative core temperature monitoring.
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