Bladder Temperature During Neonatal Targeted Temperature Management: A Case Report.

ABSTRACT

BACKGROUND: Neonatal encephalopathy is a clinical condition of altered neurological function in the first days of life. Targeted temperature management (TTM) is a validated approach to mitigate neurologic sequelae. Current literature suggests using rectal or esophageal site to assess temperature during TTM, but few studies focused on the best and the less invasive site to evaluate the temperature. This case report describes the performance of the bladder temperature monitoring during TTM. CLINICAL FINDINGS: A female newborn was born at 39 weeks' gestational age plus 4 days. At delivery, the newborn was in cardiorespiratory arrest. PRIMARY DIAGNOSIS After performing cardiopulmonary resuscitation and neurological examination, a hypoxic-ischemic encephalopathy was diagnosed. INTERVENTIONS: After about 2 hours from birth, the newborn underwent TTM. OUTCOMES: A total of 4642 measurements of rectal temperature and 4520 measurements of bladder temperature were collected. Agreement between the 2 sites was statistically significant with a mean difference of 0.064°C ± 0.219 (95% confidence interval, -0.364 to 0.494); F = 47.044; and P value of less than .001. Furthermore, difference between rectal and bladder sites was not influenced by patient's urine output ( F = 0.092, P = .762). PRACTICE RECOMMENDATIONS: Bladder temperature seems to have a good reliability and not to be inferior to the other assessment site currently used. Using bladder catheter with temperature sensor could reduce the number of devices, ensure safer stabilization, and decrease treatment downtime.