Tympanic Membrane Temperature Research Articles

Feasibility and accuracy of pediatric core temperature measurement using an esophageal probe inserted through the gastric lumen of a second-generation supraglottic airway device: a prospective observational study.

Accurate core temperature measurement in children is crucial; however, measuring esophageal temperature (TE) using a supraglottic airway device (SAD) can be challenging. Second-generation SADs, which have a gastric channel, can measure TE, and reduce gastric air volume. This study aimed to compare TE, measured using a probe inserted through the SAD gastric channel, with tympanic membrane (TTM) and forehead (TZHF) temperatures, measured using a zero-heat-flux cutaneous thermometer, with rectal temperature (TR). Temperature was recorded at 10-min intervals from 10 min after probe insertion until completion of surgery. We performed an equivalence test to evaluate whether the TE, TTM, and TZHF were equivalent to TR, with a margin of 0.3°C. Additionally, intraclass correlation coefficients (ICC) were calculated to assess the reliability of TE and TR at each time point. We included 41 patients in the final analysis. In all patients, the esophageal probe was successfully inserted through the gastric channel of the SAD. When assessing agreement with TR as a reference, TE demonstrated equivalent results at all time points (P < 0.001 at 0, 10, 20, 30, and 40-min intervals and P = 0.018 at the 50-min interval), except at the completion of surgery (P = 0.697). TE also demonstrated good reliability with TR as a reference throughout the surgery (ICC > 0.75). In children with SAD insertion, TE can be accurately and feasibly measured through the SAD's gastric channel, making it suitable for routine application.

Impact of personal protective equipment on wearer's health indicators using multi-parameter physiological monitoring

Previous studies have primarily focused on thermal discomfort-related problems arising from wearing personal protective equipment (PPE) in hot environments. However, PPE is also extensively utilized under comfortable thermal conditions, where health-related problems may become particularly important due to hypoxia and inhalation of self-emitted bio-effluents. To evaluate the impact of wearing PPE on the health outcomes of individuals under comfortable thermal conditions, ten physiological parameters were measured under three conditions (sitting without PPE, sitting with PPE, and walking with PPE). Under light intensity activity, wearing PPE significantly increased end-tidal carbon dioxide pressure (17.9 ± 6.3 mm Hg vs 22.0 ± 5.7 mm Hg, P < 0.001) when compared to wearing no PPE, while negligible (although statistically significant) changes were observed for tympanic membrane temperature and blood oxygen saturation. It did not affect significantly respiratory frequency (RF), inspiratory carbon dioxide pressure (PICO2), heart rate (HR), pulse rate (PR), systolic/diastolic blood pressure (SBP/DBP), and potential of ST-segment (ST) in electrocardiogram. It suggests that short-term PPE use is safe under comfortable conditions. The physiological parameters of PPE wearers were more affected by the increase in activity intensity than the presence of PPE. Larger body mass index was associated with decreased RF and increased PICO2. Higher age was associated with increased HR and PR and decreased ST. Males had a lower SpO2 but a higher SBP. The data obtained improves our understanding of the health outcomes associated with wearing PPE and assists in improving PPE, thus contributing to better occupational health.

Efficacy of Intravenous Low-Dose Ketamine for Prevention of Post-Spinal Anesthesia Shivering in Cesarean Section: A Double-Blind, Randomized Controlled Study

Background: Post-spinal anesthesia shivering in cesarean section is a common complication owing to sympatholysis, resulting in vasodilation and heat redistribution from the core to peripheral parts of the body. The physiological consequences of shivering include an increase in cardiac and systemic energy expenditure, oxygen consumption, and carbon dioxide production. Ketamine, a N-methyl D-aspartate (NMDA) receptor antagonist, has been reported to have anti-shivering effects. The aim of this study is to determine the effectiveness of prophylactic low-dose intravenous (IV) ketamine (0.25 mg/kg) in preventing shivering after spinal anesthesia as compared to placebo in elective cesarean sections. Methods: A randomized, double-blind study was conducted on 80 patients aged 18 to 40 years and American Society of Anesthesiologists grade II undergoing elective cesarean section under spinal anesthesia. Groups K and group S received IV ketamine 0.25 mg/kg diluted to 5 ml in normal saline and 5 ml normal saline IV, respectively, 10 minutes after spinal anesthesia. The incidence and duration of shivering, tympanic membrane temperature, sedation score, hemodynamic parameters, and side effects were recorded. Results: The incidence of shivering in group K was 12.5% compared to 32.5% in group S (P = 0.030). The mean duration of shivering was only 0.75 ± 2.02 min in group K as compared to 2.38 ± 3.57 min in group S (P = 0.014). Mean arterial pressure and heart rate were stable in group K without any significant sedative effect. Conclusion: The use of prophylactic low-dose ketamine (0.25 mg/kg) significantly reduces the incidence and duration of spinal anesthesia-induced shivering compared to placebo.

Hybrid operating rooms and the risk of postoperative hypothermia in pregnant women with placenta previa: A retrospective cohort study.

Births at advanced maternal ages (≥ 35 years) are increasing. This has been associated with a higher incidence of placenta previa, which increases bleeding risk. Hybrid operating rooms, designed to accommodate interventions and cesarean sections, are becoming more prominent because of their dual capabilities and benefits. However, they have been associated with increased postoperative hypothermia in pediatric settings; moreover, this has not been studied in pregnant women with placenta previa. This retrospective cohort study included pregnant women diagnosed with placenta previa who underwent elective cesarean section under general anesthesia between May 2019 and 2023. The patients were categorized according to the operating room type. The primary outcome was to determine whether the hybrid operating room is a risk factor for immediate postoperative hypothermia, defined as a tympanic membrane temperature below 36.0°C. The secondary outcomes were the effects of immediate postoperative hypothermia on the durations of postanesthetic care unit and postoperative hospital stays and incidence of complications. Immediate postoperative hypothermia (tympanic membrane temperature < 36.0°C) was more prevalent in the hybrid than in the standard operating room group (20% vs. 36.6%, p = 0.033), with a relative risk of 2.86 (95% confidence interval 1.24-6.64, p < 0.001). Patients undergoing surgery in the hybrid operating room who experienced immediate postoperative hypothermia stayed longer in the postanesthetic care unit (26 min vs. 40 min, p < 0.001) and in the hospital after surgery (4 days; range 3-5 vs. 4 days; range 4-11, p = 0.021). However, the complication rates of both groups were not significantly different (11.3% vs 7.3%, p = 0.743). Hybrid operating rooms may increase the risk of postoperative hypothermia. Postoperative hypothermia is associated with prolonged postanesthetic care unit and hospital stays. Preventing hypothermia in patients in hybrid operating rooms is of utmost importance.

Effect of eardrum perforation and chronic otitis media on the results of infrared tympanic thermometer in adults: A systematic review and meta-analysis.

This study was conducted to determine whether tympanic membrane perforation or chronic otitis media affects the results of an infrared tympanic membrane thermometer in adults. A literature search was performed using PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar. Four nonrandomized studies were included in the analysis. The temperatures of the bilateral eardrums (one eardrum with normal condition [control group] and the other eardrum with perforation or chronic otitis media [experimental group]) were measured for the same subject in the studies. The mean and standard deviation of the bilateral tympanic membrane temperatures were used to calculate the mean difference (MD) with a corresponding 95% confidence interval (CI). The fixed-effect model was utilized based on the results of the heterogeneity measurement using the Chi2 test and I2 statistic. The results of a meta-analysis in the normal eardrum (control group) and perforated eardrum, chronic suppurative otitis media with tympanic membrane perforation, or chronic otitis media with cholesteatoma (experimental group) were 343 subjects (MD = 0.05; 95% CI = -0.00 to 0.11; P = .06). A meta-analysis of the normal eardrum (control group) and perforated eardrum or chronic suppurative otitis media with tympanic membrane perforation except for cholesteatoma (experimental group) found 296 subjects (MD = 0.05; 95% CI = -0.01 to 0.11; P = .10). When the temperatures of the bilateral eardrums were measured using an infrared tympanic membrane thermometer, no difference was observed between the eardrum with perforation or chronic otitis media and the normal eardrum.

Prospective comparative analysis of zero-heat-flux thermometer (SpotOn®) compared with tympanic thermometer and bladder thermometer in extremely aged patients undergoing lower extremity orthopedic surgery.

Thermoregulation is important for maintaining homeostasis in the body. It can be easily broken under anesthesia. An appropriate method for measuring core body temperature is needed, especially for elderly patients, because the efficiency of thermoregulation gradually decreases with age. Zero-heat-flux (ZHF) thermometry (SpotOn) is an alternative, noninvasive method for continuous temperature monitoring at the skin surface. The aim of this study was to examine the accuracy and feasibility of using the SpotOn sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn sensor with 2 other reliable minimally invasive methods: a tympanic membrane thermometer and a bladder thermometer. This study enrolled 45 patients aged over 80 years who were scheduled to undergo lower extremity surgery. Body temperature was measured using a SpotOn sensor, a tympanic membrane thermometer and a bladder thermometer. Agreements between the SpotOn sensor and the other 2 methods were assessed using Bland and Altman plots for repeated measures adjusted for unequal numbers of measurements per patient. Compared with bladder temperature, bias and limits of agreement for SpotOn temperature were 0.07°C ± 0.58°C. Compared with tympanic membrane temperature, bias and limits of agreement for SpotOn temperature were -0.28°C ± 0.61°C. The 3M SpotOn sensor using the ZHF method for patients aged over 80 years undergoing lower extremity surgery showed feasible measurement value and sensitivity.

Comparison of Preemptive Post-Intubation 15 Mg/KgBW Paracetamol to 0.35 Mg/KgBW Meperidine in Incidence of Post-Anesthetic Shivering

Post anesthesia shivering (PAS) is a repetitive involuntary movement of one or more muscle groups as a result of a decrease in core body temperature. Pharmacological therapy in preventing PAS may include meperidine and paracetamol. This study compared the effectiveness of paracetamol to meperidine in reducing the incidence of post-anesthesia shivering. This study used an experimental randomized double-blind comparative analytic design on patients underwent exploratory laparotomy surgery under general anesthesia at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from September 2021 to August 2022. Patients with 50 ASA 1-2 physical status were included and divided into two groups. One group received 15 mg/kg group paracetamol and the other received 0.35 mg/kg meperidine. Data on tympanic membrane temperature and hemodynamics before and after induction and after extubating were collected. Furthermore, data on the results of the assessment of the incidence and grade of shivering in each treatment group were also collected. The results of this study showed that there was a decrease in the frequency of PAS in patients receiving intravenous 15 mg/kg paracetamol (p&lt;0.05), as well as less side effects in the form of nausea and vomiting (p &lt; 0.05). The incidence and degree of shivering after general anesthesia using intravenous 15 mg/kg paracetamol was lower compared to the use of 0.35 mg/kg meperidine. In the meperidine group, the decrease in body temperature was lower than in the paracetamol group, while the incidence of nausea and vomiting in the paracetamol group was lower than in the meperidine group. In conclusion, paracetamol reduces the incidence of post-anesthesia shivering better than meperidine.

Prevalence of Postoperative Hypothermia in the Post-anesthesia Care Unit.

Unwanted postoperative hypothermia is an unpleasant event that can cause various complications. As this serious complication and its provoking causes have not been investigated sufficiently, this study was designed and conducted to determine the prevalence of hypothermia and its associated factors in the post-anesthesia care unit after elective surgery. Four hundred patients undergoing elective surgeries were enrolled in the present cross-sectional research after termination of surgery and at the time of arrival at the post-anesthesia care unit of Poursina Public University Hospital. The tympanic membrane temperature was measured and recorded at the time of arrival at the post-anesthesia care unit and every 30 minutes after arrival. The required data were collected in a researcher-made checklist and analyzed after entering the SPSS software version 25. Considering the 5% error, it can be said that the prevalence of hypothermia in patients undergoing elective surgery ranges from 20 to 28% at the time of arrival at the post-anesthesia care unit and 18.5 to 26% 30 minutes after arrival. More than a quarter of patients experienced hypothermia following elective surgery. Therefore, appropriate treatment and control measures are necessary to manage this complication, particularly in patients with predisposing risk factors and comorbidities.

Body Temperature Manipulation Increases Salivary Cortisol Independent of Exercise

The vast majority of circulating cortisol in the blood is bound and inactivated by binding proteins like corticosteroid-binding globulin (CBG) and albumin. The cortisol that is free of these binding proteins is secreted via saliva and other body fluids. Ex-vivo studies have shown that CBG binding to cortisol is temperature-dependent within the physiological range of human core body temperatures. Exercise is a standard experimental paradigm for inducing cortisol responses. However, these studies rarely consider that exercise-induced changes in core body temperature might increase free cortisol independent of psychological stress or physical exertion. We tested the effect of heat exposure without exertion or other stressors on saliva cortisol. 26 Participants (18 healthy and 8 with Major Depression MDD) sat motionless in a dry infrared sauna set to 65.5 degrees C (150 F). They had their tympanic membrane temperature and salivary cortisol measured as their body temperature increased. Exposure to exogenous heat significantly increased core body temperature from 36.93 C/98.48 F (95% CI 36.79-37.07 C, 98.23-98.73 F) to 38.42 C /101.16 F (95% CI 38.24-38.6 C, 100.83-101.48 F) after 45 minutes of heat exposure, F(15,42.33)=43.509, p<0.001. Concurrently saliva cortisol also increased significantly from 4.00 nmol/l (95%CI 1.89-6.11) to 9.87 nmol/l (95% CI 5.58-14.17), F(1,33.17)=6.64, p=0.015. Elevations in core body temperature can significantly increase free cortisol levels even in the absence of exercise or overt psychological stressors.

Non-Invasive Intracranial Pressure Monitoring.

(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients in intensive care units, as well as during long-term surgeries and interventions. The gold standard is invasive measurement and monitoring via ventricular drainage or a parenchymal probe. In recent decades, numerous methods for non-invasive measurement have been evaluated but none have become established in routine clinical practice. The aim of this study was to reflect on the current state of research and shed light on relevant techniques for future clinical application. (2) Methods: We performed a PubMed search for "non-invasive AND ICP AND (measurement OR monitoring)" and identified 306 results. On the basis of these search results, we conducted an in-depth source analysis to identify additional methods. Studies were analyzed for design, patient type (e.g., infants, adults, and shunt patients), statistical evaluation (correlation, accuracy, and reliability), number of included measurements, and statistical assessment of accuracy and reliability. (3) Results: MRI-ICP and two-depth Doppler showed the most potential (and were the most complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, and retinal vein approaches were also promising. (4) Conclusions: To date, no convincing evidence supports the use of a particular method for non-invasive intracranial pressure measurement. However, many new approaches are under development.

Associations among serum VEGF and CGRP levels with the peripheral vascular blood flow of the skin of the hands in women with Fibromyalgia

BackgroundFibromyalgia (FM) is a long-term condition of unknown physiopathology, whose hallmark symptoms are diffuse musculoskeletal chronic pain and fatigue. ObjectivesWe aimed to analyze the associations among serum vascular endothelial growth factor (VEGF) and calcitonin gene-related peptide (CGRP) levels with the peripheral temperature of the skin of both hands and the core body temperature in patients with FM and healthy controls. MethodsWe conducted a case-control observational study with fifty-three women diagnosed with FM and twenty-four healthy women. VEGF and CGRP levels were spectrophotometrically analyzed in serum by enzyme-linked immunosorbent assay. We used an infrared thermography camera to assess the peripheral temperature of the skin of the dorsal thumb, index, middle, ring, and pinkie fingertips and dorsal centre as well as the palm thumb, index, middle, ring, and pinkie fingertips, palm centre and thenar and hypothenar eminences of both hands and an infrared thermographic scanner to record the tympanic membrane and axillary temperature. ResultsLinear regression analysis adjusting for age, menopause status, and body mass index showed that serum VEGF levels were positively associated with the maximum (β = 65.942, 95% CI [4.100,127.784], p = 0.037), minimum (β = 59.216, 95% CI [1.455,116.976], p = 0.045), and mean (β = 66.923, 95% CI [3.142,130.705], p = 0.040) temperature of the thenar eminence of the non-dominant hand, as well as with the maximum temperature of the hypothenar eminence of the non-dominant hand (β = 63.607, 95% CI [3.468,123.747], p = 0.039) in women diagnosed with FM. ConclusionsMild associations were observed between serum VEGF levels and the peripheral temperature of the skin in hand areas in patients with FM; therefore, it is not possible to establish a clear relationship between this vasoactive molecule and vasodilation of the hands in these patients.

Effect of different masses, ages, and coats on the thermoregulation of dogs before and after exercise across different seasons.

Domestic dogs demonstrate a positive correlation between body mass and whole-animal metabolism but a negative relationship between body mass and lifespan in dogs. Additionally, essential physiological mechanisms in domestic dogs, such as the relationships between thermal relations and body size and age, remain poorly understood. In this study, we looked at thermoregulation in dogs of different sizes, ages, coat types, and head morphologies across three different seasons. We used tympanic membrane temperatures (Tear) and infrared thermography to observe temperature regulation in pet dogs before and after a 45-min moderate walking exercise trial. We hypothesized that Tear and heat dissipation is positively correlated with body mass. Using network analysis, we found that body mass was among the most central features for spring and summer trials, but not for the winter trials. Similarly, leg length, snout length, and paw width were the central predictors in two of the three seasons. Mediation analysis demonstrated that nose and snout length act as significant mediators of the effects of body mass on mouth temperatures in the spring. For the summer trials, nose length and paw width significantly mediated the effect of body mass on mouth temperatures. Age, however, does not seem to be a major determinant of thermoregulation in dogs according to best subset models. A cross-seasonal examination of repeated measurements showed that mouth temperature heat dissipation rates decreased with increasing temperature and humidity. Overall, our findings support our hypothesis that Tear and heat dissipation rates are positively correlated with body mass in dogs, thus, negatively correlated with mass-specific metabolism. This finding suggests that small dogs allocate a bigger proportion of their metabolism to "inefficiencies" of heat production to offset greater heat loss.

Comparison of bilateral eardrum temperatures measured using an infrared tympanic thermometer before and after surgery in patients with chronic otitis media.

This study aimed to investigate the effect of chronic otitis media (COM) and COM surgery on infrared tympanic thermometer measurements. We retrospectively reviewed the medical records of 192 patients (192 surgery cases) who underwent surgery for COM and whose bilateral tympanic membrane temperature was measured with an infrared tympanic thermometer the day before surgery and at 2, 3, 4, and 6 months after surgery. Patients underwent surgery for COM in 1 ear, the other eardrum was intact. Patients who underwent tympanoplasty, simple mastoidectomy, and canal wall up mastoidectomy, surgeries performed to preserve the ear canal, were included in group A, and patients who underwent canal wall down mastoidectomy, a surgery to remove the ear canal, were included in group B. There were 115 and 77 patients in groups A and B, respectively. The mean temperature on the side with COM measured the day before surgery was 37.09°C ± 0.325°C and the mean temperature on the opposite normal side was 37.03°C ± 0.330°C (P = .000). In group A, the eardrum temperature on the surgical and contralateral side was not statistically different after surgery (P = .439). The temperature difference between both sides of the eardrums (dTemp) changed from 0.056°C before surgery to 0.014°C after surgery (P = .008). However, in group B, which canal wall down mastoidectomy was performed, the eardrum temperature of the surgical side was higher than that on the other side (P = .001). The dTemp increased up to 0.15°C after surgery (P = .000). The temperature of the eardrum was slightly increased by COM. The COM surgeries, which preserve the ear canal, brought the temperature of the eardrum close to that of the normal eardrum, and the surgery to remove the ear canal raised the temperature of the eardrum.

Intravenous magnesium sulfate &lt;em&gt;versus&lt;/em&gt; intravenous meperidine to prevent shivering during spinal anesthesia

BACKGROUND Shivering is a frequent event during neuraxial anesthesia due to impaired central and peripheral thermoregulation control. Meperidine and MgSO4 are effective in lowering the shivering threshold. Hence, this study aimed to compare the efficacy of MgSO4 and meperidine to prevent shivering in patients undergoing spinal anesthesia.&#x0D; METHODS This was a double-blind randomized clinical trial of 100 patients divided into 2 groups. One group had MgSO4 30 mg/kg, and the other group had meperidine 0.5 mg/kg intravenously in 100 ml of 0.9% NaCl before undergoing spinal anesthesia. Participants were non-pregnant patients aged 18–65 years and had physical status I or II (based on the American Society of Anesthesiologist). Shivering was considered significant if it occurred in grade 3 or 4. Patient characteristics, shivering degree, tympanic membrane temperature, and side effects were recorded.&#x0D; RESULTS Shivering occurred 10% in the MgSO4 group and 19% in the meperidine group, with p = 0.23. Both groups had similar side effects of nausea, vomiting, and hypotension.&#x0D; CONCLUSIONS MgSO4 30 mg/kg was not superior to meperidine 0.5 mg/kg intravenously in preventing shivering in patients undergoing spinal anesthesia.

Incidence of inadvertent perioperative hypothermia in pediatric laparoscopic surgery: a prospective observational single-center study.

Abstract&#x0D; Objective&#x0D; The pediatric age group is in the risk group for Inadvertent perioperative hypothermia (IPH) due to insufficient subcutaneous adipose tissue and underdeveloped thermoregulatory responses.&#x0D; We aimed to determine the frequency of IPH in the pediatric age group undergoing laparoscopic surgery.&#x0D; Methods&#x0D; The study is prospective observational.&#x0D; Pediatric patients (1-18 years old) who underwent laparoscopic surgery under general anaesthesia were evelueted. The tympanic membrane temperature measurements of the patients (°C) were recorded before anaesthesia induction (T0) and then every 15 minutes during the surgery.&#x0D; Results&#x0D; A total of 100 patients were evaluated. The frequency of inadvertent perioperative hypothermia was detected 13 (13%). Frequency of IPH on elective surgery patients was higher than emergency surgery (

Invention of a non-invasive intracranial pressure (ICP) monitoring system – an enlightenment from a hydrocephalus study

Background Mechanical obstruction is the most common cause of shunt failure for hydrocephalic patients. However, the diagnosis is extremely challenging and often requires invasive testing methods. Thus, a simple and non-invasive technique is in urgent need to predict the intracranial pressure (ICP) of hydrocephalic patients during their post-surgical follow-up, which could help neurosurgeons to determine the conditions of the shunt system. Materials and methods Two groups of patients were enrolled in the current study. In group I, patients were enrolled as they were diagnosed with high ICP hydrocephalus and received shunt surgery. The shunt valve pressures were taken for their post-surgical ICP. Meanwhile, the participants of group II exhibited abnormally increased lumbar puncture opening pressure (LPOP; from 180 to 400 mmH2O). Both the ICP and LPOP were used to match with their corresponding tympanic membrane temperature (TMT). Results When patients’ ICP were in the normal range (group I, from 50 to 180 mmH2O), the TMT correlated with ICP in a linear regression model (R 2 = 0.59, p < 0.001). Interestingly, when patients exhibited above-normal ICP (LPOP was from 180 to 400 mmH2O), their TMT fit well with the ICP in a third-order polynomial regression (R 2 = 0.88). When the ICP was 287.98 mmH2O, the TMT approached the vertex, which was 38.54 °C. Based on this TMT-ICP algorithm, we invented a non-invasive ICP monitor system. Interestingly, a tight linear correlation was detected between the ICP data drawn from the non-invasive device and Codman ICP monitoring system (R 2 = 0.93, p < 0.01). Conclusions We believe the TMT-ICP algorithm (the Y-Jiang model) could be used for preliminary prediction of shunt malfunction as well as monitoring ICP changes.

Effect of cooperative care training on physiological parameters and compliance in dogs undergoing a veterinary examination – A pilot study

One way to reduce fear and lack of compliance during veterinary procedures is ‘cooperative care training’, training animals to voluntarily participate in husbandry and medical care. Here we assessed the effects of cooperative care training on heart rate (HR), heart rate variability (HRV), tympanic membrane temperature (TMT) and compliance (i.e., all steps of the examination completed) of dogs during a veterinary examination. A blinded controlled trial with 47 dogs (training group (TG): 26; control group (CG): 21) was carried out. Forty dogs completed the study (TG: 22, CG:18). Dogs and their owners took part in a standardized veterinary visit twice (visit interval: 140 ± 23 days). In between, the TG took part in cooperative care training (10 ± 2 group training sessions, additional training at home). Linear mixed models were calculated (fixed effects HR/HRV: group* visit* period, TMT: group* visit; random effect: dogID). Compliance (completed steps of exam) was analyzed using McNemar tests. HR/HRV was higher/lower during the veterinary examination compared to the waiting room (period: p < 0.001), indicating that the examination was more stressful. No significant differences in HR/HRV regarding group*visit were found. TMT, taken at the end of each examination, resulted in a significant group*visit interaction (p = 0.008); stress appeared increased during visit 2 in the CG whereas in the TG a heterogeneous pattern, with 42% of dogs with reduced rightward bias, was observed. Compliance was lower in the TG during the second visit (p = 0.04). Trainer and owners claimed observable improvement of behavior during training and a decrease in HR between visits correlated significantly with trainer perception of high training success (rs = −0.52, p = 0.049). Overall, transfer of trained skills to the veterinary examination performed by a team blinded to the group allocation was poor. TMT analyses and HR/HRV data within the training group, suggest that the training had differing effects on the dogs based on their previous tolerance of handling and their progress made during training. Further research how to optimize training programs, including desensitization and counterconditioning, and their outcomes is needed.

Effect of Upper Limb Warming Blanket on Body Temperature Control During Total Hip Arthroplasty and Total Knee Arthroplasty

Background: At our research facility, the body temperature is constantly monitored using a continuous-measuring ear thermometer, i.e., Nipro CE Thermo (hereafter CE Thermo). However, this temperature control assumes that the CE Thermo itself does not get affected, thus warranting the identification of influencing factors for temperature control based on their influence on the CE Thermo. We aimed to evaluate the tympanic membrane temperature of patients undergoing lower limb surgery under general anesthesia, and to explore body temperature fluctuations during anesthesia based on the tympanic membrane temperature. Methods: We selected patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) for lower extremities at the Department of Orthopedic Surgery, Okinawa Tokushukai Kamagaya General Hospital between January 2017 and March 2020. We conducted a retrospective observational study of 173 patients undergoing THA and TKA for lower extremities at a single institution. Results: We calculated and compared the tympanic temperature measurements at 5, 10, 15, 20, 25, 30, 35, and 40 min between the groups to predict the factors of temperature variation. The results of tympanic temperature measurements were analyzed using two-way analysis of variance. At the beginning of the measurement, the THA group demonstrated significantly lower values than the TKA group (P = 0.001). Conclusions: The above results necessitate further clarification of the effect of temperature fluctuation, including surgical factors, on prognosis. J Curr Surg. 2022;12(1):7-14 doi: https://doi.org/10.14740/jcs456

Introduction of a Novel, Continuous, Noninvasive Estimation of Intracranial Pressure and Cerebral Perfusion Pressure Based on Tympanic Membrane Temperature

Hydrocephalus is a common but potentially life-threatening condition. However, valve malfunction makes further diagnosis difficult. Thus, we tried to develop a noninvasive method to detect the hydrocephalus intracranial pressure (ICP) during routine follow-up. In group I, the patient was recruited because a spinal tap test was necessary for either disease diagnosis or treatment. In group II, patients were diagnosed with high ICP hydrocephalus and received shunt surgery. The tympanic membrane temperatures (TMTs) were recorded and plotted against the spinal tap pressure (STP) and shunt valve pressures. All patients in group I showed an above-normal STP (from 180 to 400 mm H2O). The STP presents with an inverted U-shaped curve when it is plotted against TMT (R2= 0.9). When the STP was 286.1 mm H2O, the TMT approached its peak value, which was 38.61°C (101.5°F). However, when ICP was in the normal range (50-200 mm H2O), the TMT correlated with ICP in a linear regression model (R2= 0.69; P < 0.001). In addition, the cerebral perfusion pressure (CPP) was calculated and plotted against TMT. The TMT-CPP was also shown as a parabola (R2= 0.74). Based on the TMT-ICP algorithm, we invented a noninvasive ICP monitor system, which performs in a manner comparable to the Codman ICP Transducer (R2= 0.9; P < 0.01). Both Y-Jiang TMT-ICP and TMT-CPP algorithms are useful to monitor the shunt outcomes and identify potential shunt failure. More importantly, these algorithms open the possibility for the rational acquisition of ICP and CPP noninvasively.

Design and application of a cooling device based on the phase-change material for heat stroke

Heat stroke is a critical and health-threatening disease, triggered by thermal stimulus and progressing rapidly. It can give rise to multiple organ dysfunction syndrome (MODS), resulting in a high mortality rate. Nearly 30% of survivors will suffer with different sequelae, for instance, the neurological sequelae. Currently, the early rapid cooling is the focus of therapy for heat stroke. Therefore, it is imperative to design a cooling module suitable for the treatment of heat stroke in the field and in the hospital to realize the goal of early rapid cooling and the effective targeted temperature management (TTM). The cooling device is composed of a cooling blanket and a cooling cap. The blanket and cap are made by temperature changeable fabric. The cooling blanket comprises a backing layer, a buffer layer, a flexible heat conduction capsule body, a temperature changing component, a fixed part and a temperature sensor. The cooling cap includes a main body and two side ears, in which the main body is worn on the top of the patient's head, and the front is equipped with a flexible display screen, which is convenient for real-time monitoring the temperature of the temperature change component of the cooling blanket. The lateral ear can wrap the patient's ears and neck, and the tympanic membrane thermometer is designed to monitor the tympanic membrane temperature in real time. The tympanic membrane thermometer is also designed at the ear to monitor the tympanic auditory canal temperatures in real time.Continuous dynamic temperature monitoring can guide the duration of cooling treatment and stop cooling in time. The cooling component is portable, easy to operate, real-time temperature monitoring, excellent cooling effect and reusable. It is used for on-site first aid, transportation and continuous cooling for patients with heat stroke in the ward.