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Published online: 2018-09-20
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Comparison of temperature measurements in esophagus and urinary bladder in comatose patients after cardiac arrest undergoing mild therapeutic hypothermia

Julia M. Umińska, Katarzyna Buszko, Jakub Ratajczak, Piotr Łach, Krzysztof Pstrągowski, Anita Dąbrowska, Piotr Adamski, Grzegorz Skonieczny, Jacek Manitius, Jacek Kubica
DOI: 10.5603/CJ.a2018.0115
·
Pubmed: 30246234

open access

Ahead of print
Original articles
Published online: 2018-09-20

Abstract

Background: Mild therapeutic hypothermia (MTH) is a recommended method of treatment for comatose out-of-hospital cardiac arrest (OHCA) survivors. However, the proper site of temperature measurement in MTH is still not defined. The aim of this study was to compare temperature measurements in the esophagus and urinary bladder in comatose post-OHCA patients treated with MTH. Methods: This temperature comparison protocol was a part of a prospective, observational, multicenter cohort study. The study population included 36 unconscious patients after resuscitation for OHCA. The patient’s core temperature was independently measured every hour during MTH in the urinary bladder and in the esophagus. Results: The mean temperature was lower in the esophagus (differences during induction phase: 1.04 ± 0.92ºC, p < 0.0001; stabilization phase: 0.54 ± 0.39ºC, p < 0.0001; rewarming phase: 0.40 ± 0.47ºC, p < 0.0001). Nevertheless, a strong correlation between both sites was found (R2 = 0.83, p < 0.001). The decrease in temperature observed in the esophagus during the induction phase was faster when compared with the urinary bladder (1.09 ± 0.71°C/h vs. 0.83 ± 0.41°C/h; p = 0.002). As a consequence, time to reach temperature < 34.0°C was longer when temperature was measured in the urinary bladder (the difference between medians of the time 1.0 [0–1.5] h, p < 0.001). Conclusions: Urinary bladder temperature measurements may lag behind temperature changes measured in the esophagus. Monitoring temperature simultaneously in the esophagus and in the urinary bladder is an accessible and reliable combination, although esophageal measurements seem to better reflect the dynamics of temperature changes, thus it seems to be more appropriate for MTH control. ClinicalTrials.gov Identifier: NCT02611934.

Abstract

Background: Mild therapeutic hypothermia (MTH) is a recommended method of treatment for comatose out-of-hospital cardiac arrest (OHCA) survivors. However, the proper site of temperature measurement in MTH is still not defined. The aim of this study was to compare temperature measurements in the esophagus and urinary bladder in comatose post-OHCA patients treated with MTH. Methods: This temperature comparison protocol was a part of a prospective, observational, multicenter cohort study. The study population included 36 unconscious patients after resuscitation for OHCA. The patient’s core temperature was independently measured every hour during MTH in the urinary bladder and in the esophagus. Results: The mean temperature was lower in the esophagus (differences during induction phase: 1.04 ± 0.92ºC, p < 0.0001; stabilization phase: 0.54 ± 0.39ºC, p < 0.0001; rewarming phase: 0.40 ± 0.47ºC, p < 0.0001). Nevertheless, a strong correlation between both sites was found (R2 = 0.83, p < 0.001). The decrease in temperature observed in the esophagus during the induction phase was faster when compared with the urinary bladder (1.09 ± 0.71°C/h vs. 0.83 ± 0.41°C/h; p = 0.002). As a consequence, time to reach temperature < 34.0°C was longer when temperature was measured in the urinary bladder (the difference between medians of the time 1.0 [0–1.5] h, p < 0.001). Conclusions: Urinary bladder temperature measurements may lag behind temperature changes measured in the esophagus. Monitoring temperature simultaneously in the esophagus and in the urinary bladder is an accessible and reliable combination, although esophageal measurements seem to better reflect the dynamics of temperature changes, thus it seems to be more appropriate for MTH control. ClinicalTrials.gov Identifier: NCT02611934.

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Keywords

cardiac arrest, mild therapeutic hypothermia, temperature measurement

About this article
Title

Comparison of temperature measurements in esophagus and urinary bladder in comatose patients after cardiac arrest undergoing mild therapeutic hypothermia

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2018-09-20

DOI

10.5603/CJ.a2018.0115

Pubmed

30246234

Keywords

cardiac arrest
mild therapeutic hypothermia
temperature measurement

Authors

Julia M. Umińska
Katarzyna Buszko
Jakub Ratajczak
Piotr Łach
Krzysztof Pstrągowski
Anita Dąbrowska
Piotr Adamski
Grzegorz Skonieczny
Jacek Manitius
Jacek Kubica

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