Am J Crit Care 2002 Jan;11(1):38-45; quiz 47
University of Washington School of Nursing, Seattle, USA.
[Medline record in process]
Body temperature of patients in critical care units can be monitored with a variety of devices and at a variety of body sites. In recent years, monitoring of urinary bladder temperature has become more common. Temperature-sensing indwelling urinary catheters allow continuous drainage of urine and continuous measurement of body temperature. This article provides a comprehensive and critical review of research undertaken in intensive care units to compare body temperatures measured in the urinary bladder with temperatures measured at a core site, the pulmonary artery. The studies support the use of urinary bladder temperature as a reliable index of core temperature during times of thermal stability. For critically ill patients who are already under considerable stress and whose condition necessitates the use of an indwelling urinary catheter, bladder temperature monitoring is an easy and convenient method that eliminates the need to use alternative sites. Further studies on the effects of shivering and urinary flow rate on temperatures measured in the bladder in critical care patients are needed. The economics of monitoring urinary bladder temperature also should be studied.
PMID: 11785556, UI: 21642832
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Ann Intern Med 2001 Dec 18;135(12):1052-60
Hospital of the University of Pennsylvania, 3400 Spruce Street, 3 Silverstein, Philadelphia, PA 19104, USA. heidi.wald@uphs.upenn.edu
Publication Types:
PMID: 11747384, UI: 21614302
Br J Anaesth 2001 Aug;87(2):330P-375P
PMID: 11493515, UI: 21384827
Br J Anaesth 2001 Aug;87(2):289-91
Department of Anaesthesia and Intensive Care and Sheffield University, Sheffield S10 2JF, UK.
Heat and moisture exchanging filters (HMEFs) can be blocked by secretions. We have studied HMEF performance under wet conditions to see which particular design features predispose to this complication. Dar Hygrobac-S (composite felt filter and cellulose exchanger), Dar Hygroster (composite pleated ceramic membrane and cellulose exchanger) and Pall BB22-15 (pleated ceramic membrane) HMEFs were tested. Saline retention, saline concealment, and changes in air flow resistance when wet were assessed. The cellulose exchanger in the composite Hygrobac-S and Hygroster retained saline, producing a 'tampon' effect, associated with bi-directional air flow resistances in excess of the international standard of a 5 cm H(2)O pressure drop at 60 litre min(-1) air flow. Furthermore, high air flow resistances occurred before free saline was apparent within the transparent filter housing. The pleat only BB22-15 showed a significant increase in expiratory air flow resistance, but only after the presence of saline was apparent. These data imply that composite HMEFs with cellulose exchangers are more likely to block or cause excessive work of breathing as a result of occult accumulation of patient secretions than pleat only HMEFs.
PMID: 11493505, UI: 21384817
Br J Anaesth 2001 Aug;87(2):183-5
PMID: 11493485, UI: 21384797
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