婴幼儿体温.pdf

Infant hypothermia: core temperature <36.0 ℃ Anesthetic Effects  Basal metabolic rate is reduced by up to ~30%  anyrepresents existing vasoconstrictor Core temperature the is abolished temperature ofactivity the deep thoracic,  the core/skin temperature abdominal, and central nervous system onset thresholds for shivering tissues. are reduced by 2–4°C core temperature skin temperature 鼓膜 鼻咽腔 前额 ? 腋下 食道 腹部 2 1 assess the sensitivity and specificity of these methods for detecting hypothermia accuracy of separate correction factor models for estimating core temperature  aged 0–36 months  scheduled for elective lower abdominal surgery (hernia repair, removal of peripheral skin lesions, orchiopexy, hydrocele repair, or circumcision)  ASA I or II  undergo standardized general anesthesia Oral dose acetaminophen 20mg/kg Midazolam 0.5mg/kg Propofol 2~4mg/kg Sevo 4~8% Cuffed endotracheal tube Laryngeal mask Ambient temperature :22.3 ±1.5°C relative humidity : 26 ±6% Patients aged 6 months or less were warmed using a forcedair blower blanket underneath set at 38.0°C 1 innserted at a depth equivalent to the distance between the tragus and the nares of each patient over the carotid artery at the exact location of the maximal carotid pulse by palpation 2 3 4 pit on the arm along the mid-axillary line along the mid-clavicular line, one finger’s breadth below the rib cage Modeling group (28) X0=Tnaso-Tsk X0=β0+β1[Body mass] +β2[Body surface area-to-mass ratio]+ β3[%bodyfat ]+β4[heating blanket] Validation group (20) Tnaso_pred=Tsk+Cf 1 2 1 Body surface area=（W0.425×H0.725）×0.007184 2 Body fat percentage Tnaso_pred=Tsk+Cf 预测鼻咽腔温度与实测温度的差值 Bland-Altman 测量方法一致性分析 拟合优度检测 Abdomen R 2 ：确定系数 axilla carotid skin temperature measured over the carotid artery, when employed with a fixed correction factor of +0.52°C 少 窄（35.2~37.9) Carotid artery Modeling group/validation group