Thermal mapping: Assessing the optimal sites for temperature measurement in the human body and emerging technologies.

Numerous body locations have been utilized to obtain an accurate body temperature. While some are commonly used, their accuracy, response time, invasiveness varies greatly, and determines their potential clinical and/or research use. This review discusses human body temperature locations, their accuracy, ease of use, advantages, and drawbacks. We explain the concept of core body temperature and which of the locations achieve the best correlation to this temperature. The body locations include axilla, oral cavity, rectum, digestive and urinary tracts, skin, tympanic, nasopharynx, esophagus, and pulmonary artery. The review also discusses the latest temperature technologies, heat-flux technology and telemetric ingestible temperature pills, and the body locations used to validate these devices. Rectal and esophageal measurements are the most frequently used.

Efeito da termometria na prevenção de úlceras de pé diabético: revisão sistemática com metanálise / Effect of thermometry on the prevention of diabetic foot ulcers: a systematic review with meta-analysis* / Efecto de la termometría en la prevención de las úlceras del pie diabético: revisión sistemática con metaanálisis

Resumo Objetivo: analisar o efeito da termometria podálica cutânea em pessoas com diabetes mellitus, comparado com prevenção padrão de úlceras podálicas adotada nesses pacientes. Método: revisão sistemática com metanálise. Protocolo registrado na PROSPERO (CRD42020202686). Foram seguidas as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Busca realizada nas fontes de dados: SCOPUS, Web of Science, MEDLINE via PubMed, MEDLINE via EBSCO, MEDLINE via Biblioteca Virtual em Saúde, Embase, CINAHL, Cochrane Library, LILACS via Biblioteca Virtual em Saúde, Google Scholar, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses & Dissertações-Capes, Open Grey e ProQuest Dissertations and Theses. O risco de viés foi avaliado pela Cochrane Collaboration Risk of Bias Tool (RoB 2), a metanálise no software Review Manager 5.4 e a Certeza da evidência no sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: dos 670 registros, cinco artigos eram elegíveis. A metanálise foi calculada para o desfecho prevenção da incidência de úlceras de pé diabético, com sumarização de efeito (RR 0,53; IC95% 0,29, 0,96; p=0,02), com certeza da evidência moderada. Conclusão: a termometria mostrou efeito protetor na incidência de úlceras de pé diabético, se comparada ao cuidado podálico padrão.

Abstract Objective: to analyze the effect of cutaneous foot thermometry in people with Diabetes Mellitus, compared with the standard prevention of foot ulcers adopted in these patients. Method: a systematic review with meta-analysis. Protocol registered with PROSPERO (CRD42020202686). The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. The search was performed in the following data sources: SCOPUS, Web of Science, MEDLINE via PubMed, MEDLINE via EBSCO, MEDLINE via Biblioteca Virtual em Saúde, Embase, CINAHL, Cochrane Library, LILACS via Biblioteca Virtual em Saúde, Google Scholar, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses & Dissertações-Capes, Open Grey and ProQuest Dissertations and Theses. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Tool (RoB 2), the meta-analysis was performed in the Review Manager 5.4 software and the Certainty of evidence in the Grading of Recommendations Assessment, Development and Evaluation system. Results: of the 670 records, five articles were eligible. The meta-analysis was calculated for the prevention of the incidence of diabetic foot ulcers outcome, with effect summarization (RR 0.53; 95%CI 0.29-0.96; p=0.02), with certainty of moderate evidence. Conclusion: thermometry showed a protective effect on the incidence of diabetic foot ulcers when compared to standard foot care.

Resumen Objetivo: analizar el efecto de la termometría cutánea del pie en personas con diabetes mellitus, en comparación con la prevención estándar de las úlceras del pie adoptada en estos pacientes. Método: revisión sistemática con metaanálisis. Protocolo registrado en PROSPERO (CRD42020202686). Se siguieron las recomendaciones de Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). La búsqueda se realizó en las fuentes de datos: SCOPUS, Web of Science, MEDLINE a través de PubMed, MEDLINE a través de EBSCO, MEDLINE a través de la Biblioteca Virtual en Salud, Embase, CINAHL, Cochrane Library, LILACS a través de la Biblioteca Virtual en Salud, Google Scholar, Biblioteca Digital Brasileña de Tesis y Disertaciones, Catálogo de Tesis y Disertaciones-Capes, Open Grey y ProQuest Dissertations and Theses. El riesgo de sesgo se evaluó mediante la Cochrane Collaboration Risk of Bias Tool (RoB 2), el metaanálisis se realizó con el software Review Manager 5.4 y la certeza de la evidencia se evaluó mediante el sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: de los 670 registros, cinco artículos fueron elegibles. El metaanálisis se calculó para el resultado prevención de la incidencia de úlceras del pie diabético, con sumarización del efecto (RR 0,53; IC95% 0,29, 0,96; p=0,02), con certeza de evidencia moderada. Conclusión: la termometría mostró un efecto protector sobre la incidencia de úlceras del pie diabético en comparación con el cuidado estándar del pie.

Screening microchip sites to predict body temperature in young calves.

Thermal microchip sensors can automate body temperature measurements. The best site of implantation is still unknown, and the accuracy and precision of body temperature predictions based on microchip data need to be investigated. The aim of this study was to investigate the best site for microchip implant for monitoring body temperature in dairy calves. Seventeen calves were used (32.2 ± 5.2 kg of body weight) and the microchips were implanted four days after birth. The microchips were implanted at navel, ear and tail base (subcutaneous), neck (cleidocephalicus) and internal face of leg (gracilis) (intramuscular). Rectal temperature (RT, °C), obtained with a clinical thermometer, was considered as core temperature. Air temperature (AT), relative humidity (RH) and the temperature and humidity index (THI) were evaluated at the same time of rectal and microchip temperature measurements over 56 days. The range of AT, RH and THI was 7.6-34.4 °C, 17.5-99.0% and 50.6 to 91.5. The average for rectum, ear, neck, tail, leg, and navel were 38.7; 36.9; 38.0; 37.0, 37.8 and 37.0 °C. The intramuscular implantations had closest values to RT. The correlations between RT and ear, neck, tail, leg, and navel temperatures were 0.56, 0.60, 0.60, 0.53 e 0.48. The RT prediction based on microchip data had precision (rc) ranged between 0.49 and 0.60 and accuracy (Cb) between 0.79 and 0.88. The inclusion of AT, RH and THI as predictive variables in models decrease the mean absolute error (23%) and increase the precision (21.3%) and accuracy (10.2%). The Concordance Correlation Coefficient and root-mean-square error for equations using tail or neck microchips were 0.68 and 0.67, and 0.29 and 0.28 °C, respectively. The tail base is a promising site for microchip implantation to predict rectal temperature. The inclusion of air temperature as a predictive variable in the models is recommended.

Interventionist videothermometry: a new model of cardiac ischemia evaluation.

BACKGROUND: The purpose of the present study was to evaluate, through videothermometry, the temperature variation in the hearts of rabbits, that underwent induced myocardial ischemia and reperfusion. RESULTS: A total of 20 female rabbits were divided into two groups: a treated group and a sham group, the treatment group underwent 5 min of cardiac arrest and reperfusion, using the inflow occlusion technique. Throughout the experiment, the animals were monitored by videothermometry, observing the thermal variations of the myocardial tissue. During the experiment, at different times, blood gas tests and tests to evaluate the lactate concentrations were performed. At the end of the experiment, each heart was submitted to histopathological evaluation. In the treated group, there was a reduction in temperature of the myocardial tissue during the circulatory arrest compared to the sham group. Additionally, a colder area next to the caudal vena cava ostium and the right atrium was observed. Notably, despite the 5 min of cardiac arrest in the treated group, both the lactate and bicarbonate levels were maintained without significant variation. However, there was an increase in PaCO2 and pH reduction, featuring respiratory acidosis. In relation to the histopathological study, the presence of hydropic degeneration in the myocardium of animals in the treated group was observed. CONCLUSIONS: Based on these results, the videothermometry was efficient in identifying the range of myocardial tissue temperature, suggesting that the first areas to suffer due to cardiac arrest were the caudal vena cava ostium and the right atrium. However, in regard to the angiographic coronary thermography, the study was not feasible due to the small size of the coronary. There was no variation between the groups regarding the presence of myocardial infarction, myocardial congestion, myocardial edema and myocardial hemorrhage.

Infrared enthalpymetric methods: A new, fast and simple alternative for sodium determination in food sauces.

This work developed a new technique and an application of an existing approach to determine sodium in food sauces, involving enthalpimetric reactions in the infrared. Infrared Thermometric Titration (TT-IR) was utilized, with simple analyzers and low-cost measurement instruments for the acquisition of the surface temperature generated in the sodium precipitation reaction and development of software for the acquisition and processing of data using Raspberry Pi. The sodium was also quantified by Thermal Infrared Enthalpimetry (TIE), a recently developed technique. The rapid and simple quantification of sodium by the TT-IR and TIE showed the possibility of a selective reaction for sodium, using aluminum nitrate, potassium and ammonium fluoride in an acid medium, with reduction of the reagents and without the digestion step in the sample preparation. The results acquired through TT-IR and TIE corroborated the Flame Atomic Emission Spectrometry (FAES) with 96 to 103% and 95 to 102%, respectively.

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats.

PURPOSE: To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes. METHODS: Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals. RESULTS: Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP. CONCLUSIONS: Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats

Purpose:To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes.Methods:Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals.Results:Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP.Conclusions:Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.(AU)

Métodos de termometria não invasiva em comparação oa método de aferição da temperatura de cateter de artéria pulmonar: um estudo de medidas repetidas / Comparison of noninvasive methods of thermometry and the pulmonary artery, temperature method: a repeated measures study

A aferição da temperatura corporal é uma ferramenta essencial no cuidado de pacientes críticos. Para a identificação da temperatura corporal é necessário o uso de um termômetro preciso e ágil. Quando técnicas invasivas não estão sendo utilizadas, a equipe de enfermagem depende de termômetros não invasivos. Atualmente, na literatura, não há um consenso sobre a acurácia e precisão de métodos como as temperaturas oral, axilar, de membrana timpânica ou de artéria temporal. Ademais evidências acerca dos fatores que podem alterar a confiabilidade desses métodos são escassas. Por isso estudos clínicos devem ser realizados com esses métodos para respaldar o uso dessas técnicas na prática. Objetivo: Comparar a acurácia e precisão de métodos de termometria não invasivas (artéria temporal, membrana timpânica, oral e axilar) em comparação a temperatura de artéria pulmonar. Método: Foram realizados uma revisão sistemática e metanálise e um estudo clínico de medidas repetidas. A metanálise foi realizada com dados de 41 artigos pesquisados na literatura. Os dados do estudo clínico foram coletados em duas Unidades de Terapia Intensiva na cidade de Belo Horizonte. Foram incluídos pacientes adultos em uso do cateter de artéria pulmonar. As cinco temperaturas foram aferidas três vezes de cada paciente. Para análise dos dados foi realizada análise descritiva, gráficos de Bland-Altman e análises de regressão. Resultados: A acurácia e precisão das temperaturas na metanálise foram; temperatura axilar, -0,35 e 0,06; temperatura oral, -0,21 e 0,08; temperatura de membrana timpânica, -0,05 e 0,05; e temperatura de artéria temporal, -0,22 e 0,26. A acurácia e precisão após análise dos dados do estudo clínico foram, respectivamente: temperatura axilar, -0,42 e 0,59; temperatura oral, -0,30 e 0,37; temperatura de membrana timpânica, -0,21 e 0,44; e temperatura de artéria temporal, -0,25 e 0,61. Conclusão: Os termômetros não invasivos mostraram uma boa acurácia e precisão em relação a temperatura de artéria pulmonar, entretanto em pacientes com alterações da temperatura os termômetros não invasivos tornam-se pouco acurados.(AU)

The identification of body temperature is an essential tool in critical care nursing. The use of a reliable and agile thermometer is necessary to identify the real body temperature. When available, invasive thermometer are indicated for its precision. Although, when not available, the nursing staff must rely in noninvasive thermometers. Nowadays, in the literature, there isn´t a consensus about the reliability of noninvasive temperature techniques, such as axillary, oral, tympanic membrane and temporal artery. Furthermore, there is a lack of knowledge about factors that alters the reliability of those thermometers. Clinical studies must be developed to back these techniques in nursing care. Aim: Compare the accuracy and precision of noninvasive techniques (axillary, oral, tympanic membrane and temporal artery) with the pulmonary artery temperature. Methods: An Systematic review/Metanalysis and a Cross-sectional Repeated measure clinical study were developed. The Metanalysis used data from 41 published articles. The data for the clinical study were collected in two intensive care units of two hospitals in Belo Horizonte. Patients with pulmonary artery catheter were included. The five temperatures were measured three times in each patient. Descriptive analyses were made, Bland-Altmann graphics were plotted and a four regression models were developed. Results: The accuracy and precision identified in the Metanalysis were: axillary, -0,35 and 0,06; oral, -0,21 and 0,08; tympanic membrane, -0,05 and 0,05; and temporal artery, -0,22 and 0,26. The accuracy and precision of the noninvasive thermometers and the pulmonary artery temperature identified in the clinical study were: axillary -0,42 and 0,59; oral -0,30 and 0,37; tympanic membrane -0,21 and 0,44; and temporal artery -0,25 and 0,61. Conclusion: The noninvasive thermometers showed a good accuracy and precision when compared with the pulmonary temperature, However, in non-normothermic patients the reliability of the thermometers is poor.(AU)

Videothermometry to evaluate metabolic activity in real time during pneumectomy in rats

Abstract Purpose: To evaluate, in rats, the open field videothermometry in real time while performing left pneumonectomy for early diagnosis of cardiopulmonary changes. Methods: Twelve non-specific pathogen-free Wistar rats were randomly allocated into two groups; pneumectomy group (GP) and sham surgery group (GS). Mean arterial pressure, videothermometry in real time, of the right lung, and histopathological analysis of the remaining lung were evaluated in all animals. Results: Videothermometry in real time allowed identification of temperature variance of right lung after pneumectomy, indicating a significant decrease in temperature during evaluation. There was a statistical difference between M0 and M1, M1 and M2 and M0 and M2 (p<0.004) in GS, and significant difference between M0 and M1, M1 and M2, and M2 and M0 with p<0.0001 in GP. Conclusions: Left pneumonectomy in rats shows initial histopathological changes after 60 minutes of its completion, indicating a possible compensation beginning. The open-field videothermometry in real time proved to be efficient identifying the temperature changes of the remaining lung.

In Vivo Ischemia Detection by Luminescent Nanothermometers.

There is an urgent need to develop new diagnosis tools for real in vivo detection of first stages of ischemia for the early treatment of cardiovascular diseases and accidents. However, traditional approaches show low sensitivity and a limited penetration into tissues, so they are only applicable for the detection of surface lesions. Here, it is shown how the superior thermal sensing capabilities of near infrared-emitting quantum dots (NIR-QDs) can be efficiently used for in vivo detection of subcutaneous ischemic tissues. In particular, NIR-QDs make possible ischemia detection by high penetration transient thermometry studies in a murine ischemic hindlimb model. NIR-QDs nanothermometers are able to identify ischemic tissues by means of their faster thermal dynamics. In addition, they have shown to be capable of monitoring both the revascularization and damage recovery processes of ischemic tissues. This work demonstrates the applicability of fluorescence nanothermometry for ischemia detection and treatment, as well as a tool for early diagnosis of cardiovascular disease.

Body surface infrared thermometry in patients with central venous cateter-related infections.

OBJECTIVE: To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections. METHODS: Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject. RESULTS: A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus-0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus-0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus-0.22 - -0.10ºC; p<0.01). CONCLUSION: Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Body surface infrared thermometry in patients with central venous cateter-related infections / Termometria infravermelha da superfície corporal em pacientes com infecção relacionada a cateter venoso central

Objective To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections.Methods Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject.Results A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus-0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus-0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus-0.22 - -0.10ºC; p<0.01).Conclusion Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Objetivo Avaliar se a temperatura da superfície corporal nas proximidades da área de inserção do cateter venoso central é diferente quando os pacientes desenvolvem infecções da corrente sanguínea relacionadas ao cateter.Métodos Estudo transversal observacional. Usando um termômetro infravermelho sem contato, 3 medições consecutivas de temperatura da superfície corporal foram coletadas de 39 pacientes com cateter venoso central nos seguintes locais: nas proximidades da área de inserção do cateter ou do reservatório do cateter totalmente implantável, na região contralateral equivalente (sem cateter), e na fronte do mesmo paciente.Resultados Um total de 323 observações foram coletadas. Respectivamente nos pacientes do sexo masculino e feminino, desconsiderando a ocorrência de infecção, a temperatura média na área do cateter menos a da região contralateral (média ± desvio padrão: -0,3±0,6°C versus -0,2±0,5°C; p=0,36) e a da área do cateter menos a da fronte (média ± desvio padrão: -0,2±0,5°Cversus -0,1±0,5°C; p=0,3) resultaram em valores negativos. Além disso, em pacientes infectados, foram obtidos valores mais elevados na área do cateter (IC95%: 36,6-37,5ºC versus36,3-36,5ºC; p<0,01) e nas subtrações de temperaturas: área do cateter menos região contralateral (IC95%: -0,17 - +0,33°C versus-0,33 - -0,20°C; p=0,02) e a área do cateter menos fronte (IC95%:-0,02 - +0,55°C versus -0,22 - -0,10ºC; p<0,01).Conclusão Utilizando um termômetro infravermelho sem contato, os pacientes com infecções da corrente sanguínea associadas ao cateter apresentaram valores de temperatura mais elevados, tanto ao redor da área de inserção do cateter e na subtração das temperaturas das regiões contralateral e fronte, em relação àquelas da área do cateter.