Abstract 18063: Nasopharyngeal And/or Rectal Temperatures: Can They Be Used as Reliable Indirect Measures of Brain Temperature in Ischemic Stroke Patients Undergoing Mild Hypothermia?
Introduction: Hypothermia therapy has been proven to have neuroprotective effects for patients with ischemic stroke. To ensure efficacy of the therapy, it is imperative to develop reliable non-invasive measurements of brain temperature (BT). As the accuracy and the sensitivity of various indirect brain temperature measurements have yet to be established, this study was designed to determine the validity of two non-invasive measures (the nasopharyngeal temperature, NPT and rectal temperature, RT) to predict BT in ischemic stroke patients undergoing therapeutic hypothermia.
Method: Fifty-four ischemic stroke patients who underwent hypothermia in the Neurological ICU of a teaching hospital were recruited. With direct BT measure as the gold standard, BT, NPT and RT were monitored simultaneously and recorded 60 minutes pre-hypothermia and every 60 minutes for the duration of the therapy. A total of 5850 temperature sets were obtained. Receiver operating characteristic (ROC) curves were employed to determine the optimal cut off points and tests of sensitivity, specificity, false positive rates, kappa coefficients as well as linear regression analyses were conducted.
Results: The average age of participants (male 32, female 22) was 59.2 ± 9.3 years. . The BT ranged from 31.4°C to 39.8°C. The overall diagnostic agreement was substantial for NPT and RT, with κ values of 0.901 and 0.788, respectively. The sensitivity, specificity and false positive rates were, 97.6%, 92.4%, and 10.1%, respectively, for NPT; and 96.8%, 82%, and 19.7%, respectively, for RT. According to ROCs, 32.3°C - 34.9°C and 32.4°C-35.0°Cwere the ideal cut offs for NPT and RT respectively in reflecting the BT of 32°C-35°C (a typical temperature range required for the hypothermia).
Conclusions: In comparison with RT, NPT appeared to be a more reliable measure although both measurements demonstrated adequate validity, thus are well suited as indirect measures for BT monitoring in ischemic stroke patients treated with hypothermia .
Author Disclosures: J. Zhao: None. P. Yue: None. M. Li: None. S. Lu: None. Y. Wu: None.
- © 2014 by American Heart Association, Inc.