| Placement of esophageal stethoscope by acoustic criteria does not consistently yield an optimal location for the monitoring of core temperature. | |
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MedLine Citation:
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PMID: 2230855 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The esophageal stethoscope has evolved into a device for both acoustic and core temperature monitoring. To test whether routine placement according to acoustic criteria results in placement of the core temperature sensor in the region of contiguity between the esophagus and the heart, we determined the depth of placement electrocardiographically. All patients were undergoing nonthoracic elective operations requiring general anesthesia and tracheal intubation. First, we established that different observers selected the same esophageal depth within +/- 1 cm electrocardiographically, using the criterion of a symmetric biphasic P wave of maximal amplitude (7 patients). Then, in 30 more patients, we compared routine acoustic placements with the depths of the maximal-amplitude biphasic P wave. Stethoscopes placed according to acoustic criteria were within +/- 3 cm of P-wave depths in 15 of 30 patients. In the remaining patients, measured discrepancies ranged up to 13.5 cm. We conclude that the prevailing stethoscope design, with a thermistor at the tip, below the acoustic window, does not ensure placement of the thermistor within the optimal region for monitoring of core temperature. A modification in design that would take advantage of the reliability of electrocardiographic positioning is suggested. |
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Authors:
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P R Freund; G L Brengelmann |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of clinical monitoring Volume: 6 ISSN: 0748-1977 ISO Abbreviation: J Clin Monit Publication Date: 1990 Oct |
Date Detail:
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Created Date: 1990-12-04 Completed Date: 1990-12-04 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8506707 Medline TA: J Clin Monit Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 266-70 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of Washington, Seattle. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acoustics Adult Aged Atrial Function, Left / physiology Auscultation / instrumentation* Body Temperature* / physiology Electrocardiography Equipment Design Esophagus* / anatomy & histology, physiology Heart Auscultation / instrumentation* Humans Middle Aged Monitoring, Intraoperative Reproducibility of Results Respiratory Sounds* / physiology Single-Blind Method Thermometers* |
| Grant Support | |
ID/Acronym/Agency:
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HL-16910/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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