Thorac Cardiovasc Surg 2007; 55(7): 442-446
DOI: 10.1055/s-2007-965371
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Evaluation of a Wireless Ingestible Temperature Probe in Cardiac Surgery

G. A. Markides1 , S. Omorphos1 , C. Kotoulas1 , B. Prendergast1
  • 1Manchester Heart Centre, Manchester Royal Infirmary, Manchester, United Kingdom
Further Information

Publication History

received February 14, 2007

Publication Date:
28 September 2007 (online)

Abstract

Objectives: CorTemp™ is a wireless intestinal temperature monitoring system in the form of an ingestible pill and an external receiver. The aim of the study was to evaluate the system's accuracy and practicality during cardiac surgery. Methods: A repeat measures design using simultaneous temperature readings from the pulmonary artery (Tpa), a nasopharyngeal thermometer (Tnp), skin thermometers (Tsk) and the CorTemp™ system (Tin), was conducted in 15 patients undergoing elective cardiac surgery under hypothermic conditions. Results: Only 67 % of patients' data was analysed and the statistical analysis of a total of 264 sets of readings showed a clinically significant temperature difference of Tin compared to the other thermometers with limits of agreement between Tin and Tpa, Tnp and Tsk (± 0.35 to ± 1.53 °C), (± 0.72 to ± 1.63 °C) (± 0.40 to ± 1.84 °C), respectively. The Tin bias was significantly different from that of Tpa (p = 0.0023), Tnp (p = 0.018) and Tsk (p = 0.0005) during rewarming. The Tin rate of temperature change was also found to be significantly slower during the rewarming period. Conclusions: The significant temperature differences detected during rewarming urge caution regarding CorTemp™'s use as an accurate estimator of brain temperature in cardiac surgery. Further studies are required to assess its potentially useful role as a body core and intestinal temperature monitoring system and as a useful adjunct in investigating bowel ischaemia aetiology in cardiac surgery.

References

  • 1 El-Rahmany H, Frank S, Vannier C, Schneider G, Okasha A, Bulcao C. Determinants of core temperature at the time of admission to intensive care following cardiac surgery.  J Clin Anesth. 2000;  12 177-183
  • 2 Sessler D. Perioperative heat balance.  Anesthesiology. 2000;  92 578-596
  • 3 Cook D. Cerebral hyperthermia and cardiac surgery: consequences and prevention.  Semin Thorac Cardiovasc Surg. 2001;  13 176-183
  • 4 Kaukuntla H, Harrington D, Bilkoo I, Clutton-Brock T, Jones T, Bonser R. Temperature monitoring during cardiopulmonary bypass - do we undercool or overheat the brain?.  Eur J Cardiothorac Surg. 2004;  26 580-585
  • 5 Ahonen J, Salmenpera M. Brain injury after adult cardiac surgery.  Acta Anaesthesiol Scand. 2004;  48 4-19
  • 6 Mcilvoy L. Comparison of brain temperature to core temperature: a review of the literature.  J Neurosci Nurs. 2004;  36 23-31
  • 7 Insler S, O'Connor M, Leventhal M, Nelson M, Starr N. Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery.  Ann Thorac Surg. 2000;  70 175-181
  • 8 Mittal B, Sathiaseelan V, Rademaker A, Perce M, Johnson P, Brand W. Evaluation of an ingestible telemetric temperature sensor for deep hyperthermia applications.  J Radiat Oncol. 1991;  21 1353-1361
  • 9 Coyne M, Kesick C, Doherty T, Kolka M, Stephenson L. Circadian rhythm changes in core temperature over the menstrual cycle: method for noninvasive monitoring.  Am J Physiol Regul Integr Comp Physiol. 2000;  279 R1316-R1320
  • 10 Hamilos D, Nutter D, Gershtenson J, Redmond D, Di Clementi J, Schmaling K, Make B, Jones J. Core body temperature is normal in chronic fatigue syndrome.  Biol Psychiatry. 1998;  43 293-302
  • 11 Leclerc S, Lacroix V, Montgomery D. Body temperature homeostasis during a 40 km open water swim.  J Swimming Research. 2000;  14 26-32
  • 12 White L, Jackson F, McMullen M, Lystad J, Jones J, Hubers R. Continuous core temperature monitoring of search and rescue divers in extreme conditions.  Prehosp Emerg Care. 1998;  2 280-284
  • 13 Fortney S, Mikhaylov V, Lee S, Kobzev Y, Gonzalez R, Greenleaf J. Body temperature and thermoregulation during submaximal exercise after 115-day spaceflight.  Aviat Space Environ Med. 1998;  69 137-141
  • 14 Kolka M, Quigley M, Blanchard L, Toyota D, Stephenson L. Validation of a temperature telemetry system during moderate and strenuous exercise.  J Therm Biol. 1993;  18 203-210
  • 15 O'Brien C, Hoyt R, Buller M, Castellani J, Young A. Telemetry pill measurement of core temperature in humans during active heating and cooling.  Med Sci Sports Exerc. 1998;  30 468-471
  • 16 Maxton F, Justin L, Gillies D. Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods.  J Adv Nurs. 2003;  45 214-222
  • 17 Robinson J, Charlton J, Seal R, Spady D, Joffres M. Oesophageal, rectal, axillary, tympanic and pulmonary artery temperatures during cardiac surgery.  Can J Anaesth. 1998;  45 317-323
  • 18 Bernard G, Sopko G, Cerra F, Demling R, Edmunds H, Kaplan S, Kessler L, Masur H, Parsons P, Shure D, Webb C, Weimann G, Williams D. Pulmonary artery catheterization and clinical outcomes.  JAMA. 2000;  283 2568-2572
  • 19 Stone J, Young W, Smith C, Solomon R, Wald A, Ostapkovich N, Shrebnick D. Do standard monitoring sites reflect true brain temperature when profound hypothermia is rapidly induced and reversed?.  Anesthesiology. 1995;  82 344-351
  • 20 Cook D. Changing temperature management for cardiopulmonary bypass.  Anesth Analg. 1998;  88 1254-1271
  • 21 Grocott H, Newman M, Croughwell N, White W, Lowry E, Reves J. Continuous jugular venous versus nasopharyngeal temperature monitoring during hypothermic cardiopulmonary bypass for cardiac surgery.  J Clin Anesth. 1997;  9 312-316
  • 22 Lee S, Williams W, Schneider S. Core temperature measurement during submaximal exercise: esophageal, rectal, and intestinal temperatures. NTRS [serial on the internet]. 2000 Apr [cited 2005 Jun 26]. Available from: http://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20000036595_2000047921.pdf
  • 23 Sicsic J, Duranteau J, Corbineau H, Antoun S, Menestret P, Sitbon P, Leguerrier A, Logeais Y, Ecoffey C. Gastric mucosal oxygen delivery decreases during cardiopulmonary bypass despite constant systemic oxygen delivery.  Anesth Analg. 1998;  86 455-460
  • 24 Lazenby W, Ko W, Zelano J, Lebowitz N, Shin Y, Isom O, Krieger K. Effects of temperature and flow rate on regional blood flow and metabolism during cardiopulmonary bypass.  Ann Thorac Surg. 1992;  53 957-964
  • 25 Slater J, Orszulak T, Cook D. Distribution and hierarchy of regional blood flow during hypothermic cardiopulmonary bypass.  Ann Thorac Surg. 2001;  72 542-547
  • 26 Boston U, Slater J, Orszulak T, Cook D. Hierarchy of regional oxygen delivery during cardiopulmonary bypass.  Ann Thorac Surg. 2001;  71 260-264
  • 27 O'Dwyer C, Woodson L, Conroy B, Lin C, Deyo D, Uchida T, Johnston W. Regional perfusion abnormalities with phenylephrine during normothermic bypass.  Ann Thorac Surg. 1997;  63 728-735
  • 28 Kumle B, Boldt J, Suttner S, Piper S, Lehmann A, Blome M. Influence of prolonged cardiopulmonary bypass times on splanchnic perfusion and markers of splanchnic organ function.  Ann Thorac Surg. 2003;  75 1559-1564
  • 29 Decking U, Pai V, Bennett E, Taylor J, Fingas C, Zanger K, Wen H, Balaban R. High-resolution imaging reveals a limit in spatial resolution of blood flow measurements by microspheres.  Am J Physiol Heart Circ Physiol. 2004;  287 1132-1140
  • 30 Groeneveld A. Tonometry of partial carbon dioxide tension in gastric mucosa: use of saline, buffer solutions, gastric juice or air.  Crit Care. 2000;  4 201-204

Dr. PhD, FETCS Christophoros Kotoulas

Cardiothoracic Surgery Department
Manchester Heart Centre
Manchester Royal Infirmary

Oxford Road

M13 9WL Manchester

United Kingdom

Phone: + 44 16 12 76 59 62

Fax: + 44 16 12 76 85 22

Email: chrkotoulas@hol.gr

    >