Article Text

PDF

1106 Impact of Warmed Inhaled Gas from the Mechanical Ventilator on Esophageal Temperature During Whole Body Hypothermia for Hypoxic-Ischemic Encephalopathy
  1. S Sarkar1,
  2. SS Sarkar2,
  3. I Bhagat3,
  4. R Dechert1,
  5. SM Donn1
  1. 1Department of Pediatrics, Division of Neonatal-Perinatal Medicine
  2. 2Research Volunteer, Division of Neonatal-Perinatal Medicine, University of Michigan Health System
  3. 3Pediatrics, St Joseph Mercy Hospital, Ann Arbor, MI, USA

Abstract

During whole body cooling (WBC), the core temperature is monitored with either an esophageal or a rectal probe. Most infants are usually on mechanical ventilation while receiving hypothermia. As the temperature in the esophagus responds rapidly to changes in the ambient temperature, inhalation of warmed gas from ventilator during hypothermia may lead to overestimation of ventilated patients’ actual temperature, causing automated cooling devices to overcool patients well below set temperature targets.

Objective We determined if the esophageal temperature recordings during therapeutic WBC differ between ventilated and non-ventilated infants.

Methods Twenty-two consecutively cooled infants had simultaneous esophageal and rectal temperatures recorded every 4 hours during 72 hours of WBC. The later was deemed to be actual core temperature. Other clinical monitoring and treatment during hypothermia were as per established protocol.

Results Fourteen infants received mechanical ventilation throughout cooling. The remaining 8 infants were on ventilator initially but got extubated and were not on ventilator during 32 to 72 hours section of WBC. Esophageal temperatures were significantly higher than simultaneous rectal temperatures (p≤0.01 at each time point) for all 22 infants. However, the esophageal temperatures across every 4 hour time points during 32 to 72 hours section of WBC did not differ between the ventilated (n-14), and non-ventilated (n-8) infants. The magnitude (median, IQR) of the difference between esophageal and rectal temperatures were also similar between the 2 groups.

Abstract 1106 Figure 1

Comparison of E-R (in centigrade) between 2 groups

Conclusions Warmed inhaled gas does not interfere with the esophageal temperature during WBC.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.