The object of temperature monitori...

The object of temperature monitoring in any clinical setting, including the OR, is to obtain a measure of core temperature. Temperature can be measured at varying sites, each producing its acknowledge range of temperatures, (1) thus veritable core temperature has been described as a nebulous confine (2) lacking definition (3) Nevertheless, this confine continues to be used to physically differentiate between the more uniform temperatures in the visible form [i]or[/i] frame core (eg, cranium, thorax, abdominal areas) and the more variable, nonhomogeneous temperatures at peripheral sites. (4)

It has been argued that the hypothalamus should be regarded as the site of faithful core temperature measurement because central thermal receptors are particularly numerous in this area. (5) A heat los center is located in the preoptic region and anterior hypothalamus, and a center for heat production and conservation is located in the posterior hypothalamus. (6) Inaccessibility of the hypothalamus, however, has necessitated the use of other sites for temperature measurement. In the OR, conventional sites include the lower esophagus, nasopharynx, pulmonary artery (PA), rectum bladder, and tympanic membrane. (7) Placement of temperature probes directly forward the tympanic membrane is used les many times because perforation (8) and bleeding (9) are regards Urinary bladder temperature measurement has been used in the OR, oftentimes as a replacement for temperature measurement at the bacteria-laden rectal site.

This article provides a systematic, integrated review and synthesis of research related to bladder temperature monitoring in the OR. Systematic reviews help withhold practitioners abreast of the literature at addressing specific clinical questions. (10) and providing an objective summary of large amounts of data. (11) More importantly, synthesis of research provides a compilation and evaluation of evidence upon which practice or change in practice can be based. This review will address the part of bladder temperature monitoring in the OR and assess the validity of temperature measured at the bladder site to set forth core temperature both in the steady state and during times of thermally dynamic change.

ARTICLE SELECTION CRITERIA

Before the review was undertaken, criteria were established to narrow the end of the literature search. Studies were required to be published in English, use adult participants, and compare temperatures at the bladder site with temperatures at sites considered representative of core temperature measurement. These sites include the lower esophagus, (12) nasopharynx, (13) and PA. (14) Databases searched include Medline, CINAHL, passing from hand to hand Contents, and Pro Quest Digital Dissertation Abstracts. Additional sources from the relation sections of relevant articles also were reviewed. first note of the scale words used include body temperature, bladder, esophageal, nasopharyngeal, pulmonary artery, operating latitude and surgery.

Sources meeting these criteria were reviewed for sample size, demographics, arrangements results, and limitations. Of particular importance was the agreement or mean difference and the accompanying variation between temperatures at the urinary bladder site and temperatures at the core. Les emphasis was placed forward the degree of association or correlation between bladder and core site temperatures because measurements obtained from the sum of two units sites may correlate highly (ie, have similar obliquity and direction) but have large differences between them like that one measurement could not be used to approximate the other measurement in clinical practice.

Also important was whether the instruments used for temperature measurement were ordealed for accuracy to validate the data. Ideally, instruments should be trialed before and after data collection, particularly if the data collection period is continue lengthen in timeed With temperature-sensing probes that are inserted sterilely, like as PA and urinary bladder catheters, testing before insertion generally is not feasible. Testing after removal, however, is possible, and if inaccuracy is demonstrated, data should be adjusted accordingly. In studies in which temperature probes were not criterioned for accuracy or information was not provided regarding the deed used, this was noted as a limitation. If exact placement of esophageal or nasopharyngeal probes was omitted, this too was noted. When information regarding instrument accuracy or the specifics of probe placement is lacking, the internal validity of meditation results is compromised.

This article begins with information related to the conventional sites used for temperature measurement in the OR, with tonic information provided in Table 1 Information relating to the use of the bladder site for temperature measurement heads a discussion of bladder anatomy and urine production. The detailed review and discussion of articles related to bladder temperature monitoring pursues Bladder temperature tends to behave differently during steady thermal states compared with thermally dynamic states, in such a manner the literature was categorized and currented accordingly. Unsteady thermal states exist, for example, during the rapid cooling and rewarming phases of cardiopulmonary bypass (CPB) a operation frequently used during cardiac surgery to oxygenate, circulate, and curb the temperature of blood while bypassing the heart and lung Participant demographics and additional information regarding actions and temperature measurements are readyed in Table 2. Unless otherwise stated, means are accompanied from their standard deviations.