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Open AccessArticle

Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol

1
Department of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA
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Department of Pediatrics, Michigan State University College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI 49503, USA
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Office of Research Administration, Spectrum Health, 100 Michigan Street NE, Grand Rapids, MI 49503, USA
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Department of Emergency Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA
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Design Solutions, Inc., 1266 Park Road, Chanhassen, MN 55317, USA
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Department of Electrical and Computer and Engineering, Michigan State University, 2120 Engineering Building, East Lansing, MI 48824, USA
*
Author to whom correspondence should be addressed.
Healthcare 2018, 6(3), 87; https://doi.org/10.3390/healthcare6030087
Received: 21 June 2018 / Revised: 20 July 2018 / Accepted: 20 July 2018 / Published: 24 July 2018
We examined the feasibility of a thermal imager smart phone attachment as a potential proxy of skin perfusion by assessing shifts in skin temperature following administration of the vasodilatory anesthetic propofol. Four limb distal extremity thermal images were taken before propofol administration and at 5-min intervals thereafter during monitored anesthesia. The study enrolled 60 patients with ages ranging from 1.3 to 18 years (mean 10.7 years old) from April 2016 to January 2017. Five minutes following propofol administration, the median temperature differential (delta temperature) between the core and extremity skin significantly decreased in both upper and lower extremities, 7.9 to 3.6 °C (p < 0.0001) and 12.1 to 6.9 °C (p < 0.0001), respectively. By 10 min, the median delta temperatures further decreased significantly in the upper (p = 0.0068) and lower extremities (p = 0.0018). There was a concordant decrease in mean blood pressure (MBP). These trends reverted back when the subject awoke. There was no significant difference between the four operators who used the camera (p = 0.0831). Blood pressure and time temperature change was the only value of significance. Mobil thermal imaging represents a non-invasive modality to assess perfusion in real time. Further studies are required to validate the clinical utility. View Full-Text
Keywords: hemodynamics; monitored anesthesia care; perfusion; propofol; thermal imaging hemodynamics; monitored anesthesia care; perfusion; propofol; thermal imaging
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Rajasekaran, S.; Pressler, M.; Parker, J.L.; Scales, A.; Andersen, N.J.; Olivero, A.; Ballard, J.R.; McGough, R. Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol. Healthcare 2018, 6, 87.

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