The Accuracy of Temperature Measurements Provided by the Edwards Lifesciences Pulmonary Artery Catheter.
BACKGROUND
Pulmonary artery catheters (PACs) are frequently used for monitoring patient temperatures in the intensive care unit. Nevertheless, data regarding the accuracy of these measurements are lacking, and few data testify to the accuracy of temperatures recorded after the PAC has been in place for several days. The absolute values of such measurements are relevant for critical care because patient temperatures are often used as diagnostic criteria for sepsis and antibiotic therapy. We thus hypothesized that the Edwards Lifesciences PAC would accurately measure blood temperature. To test our hypothesis, we compared temperature measurements obtained from PACs inserted in patients for different lengths of time with measurements of a reference platinum resistance thermometer (PRT).


METHODS
PACs were removed and analyzed in 39 patients in whom PACs were inserted for 0 to 5 days. The PACs were placed in calibration baths, and 10 consecutive measurements at each of 7 different temperatures were obtained (36°C, 36.5°C, 37°C, 38°C, 38.3°C, 39°C, and 40°C). The temperature measurements obtained using PACs were compared with measurements obtained using a PRT. Bland-Altman statistical analyses were performed. Outliers, defined as PAC temperature measurements that varied more than ±0.3°C from PRT measurements, were identified. We considered a catheter unfit for clinical diagnostic or therapeutic use if ≥15% of data pairs were outliers.


RESULTS
A total of 2730 data pairs were analyzed. Overall, the bias was -0.15°C; the precision was +0.13°C; and the limits of agreement were -0.45°C to +0.13°C. The bias and limits of agreement did not differ according to the age of the catheter or the temperature tested. One hundred fourteen data pairs (4.2% [95% confidence interval, 2.0%-6.4%]), involving 13 PACs and mostly from 4 PACs, were outliers.


CONCLUSIONS
We conclude that temperature measurements obtained using the Edwards Lifesciences PACs are thus sufficiently accurate to be used for clinical temperature monitoring in critically ill patients.
From the *Pôle Anesthésie-Samu-Urgences-Réanimations and †Service de Pharmacologie Clinique et Centre d'Investigations Cliniques, Centre Hospitalier Universitaire de Rennes, Rennes, France.
Yoann
Y
Launey
Raphaëlle
R
Larmet
Nicolas
N
Nesseler
Yannick
Y
Malledant
Clément
C
Palpacuer
Philippe
P
Seguin
D001833:Body Temperature Regulation; D002138:Calibration; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation* / Q000592:standards; D002408:Catheters, Indwelling / Q000592:standards; D016638:Critical Illness; D004867:Equipment Design; D006801:Humans; D007362:Intensive Care Units; D008422:Materials Testing; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000592:standards; D011237:Predictive Value of Tests; D012015:Reference Standards; D015203:Reproducibility of Results; D013815:Thermodilution / Q000295:instrumentation* / Q000592:standards; D013821:Thermometers / Q000592:standards; D013997:Time Factors; D062666:Vascular Access Devices / Q000592:standards