Document Detail


Placement of esophageal stethoscope by acoustic criteria does not consistently yield an optimal location for the monitoring of core temperature.
MedLine Citation:
PMID:  2230855     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
P R Freund; G L Brengelmann
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of clinical monitoring     Volume:  6     ISSN:  0748-1977     ISO Abbreviation:  J Clin Monit     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-12-04     Completed Date:  1990-12-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8506707     Medline TA:  J Clin Monit     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  266-70     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Washington, Seattle.
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MeSH Terms
Descriptor/Qualifier:
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:
HL-16910/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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