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

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...

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Main Authors: Surender Rajasekaran, Mark Pressler, Jessica L. Parker, Alex Scales, Nicholas J. Andersen, Anthony Olivero, John R. Ballard, Robert McGough
Format: Article
Language:English
Published: MDPI AG 2018-07-01
Series:Healthcare
Subjects:
Online Access:http://www.mdpi.com/2227-9032/6/3/87
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spelling doaj-781eeae60aee413c88ac2b972cc453a12020-11-24T21:49:05ZengMDPI AGHealthcare2227-90322018-07-01638710.3390/healthcare6030087healthcare6030087Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with PropofolSurender Rajasekaran0Mark Pressler1Jessica L. Parker2Alex Scales3Nicholas J. Andersen4Anthony Olivero5John R. Ballard6Robert McGough7Department of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADepartment of Pediatrics, Michigan State University College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI 49503, USAOffice of Research Administration, Spectrum Health, 100 Michigan Street NE, Grand Rapids, MI 49503, USADepartment of Emergency Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USAOffice of Research Administration, Spectrum Health, 100 Michigan Street NE, Grand Rapids, MI 49503, USADepartment of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADesign Solutions, Inc., 1266 Park Road, Chanhassen, MN 55317, USADepartment of Electrical and Computer and Engineering, Michigan State University, 2120 Engineering Building, East Lansing, MI 48824, USAWe 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.http://www.mdpi.com/2227-9032/6/3/87hemodynamicsmonitored anesthesia careperfusionpropofolthermal imaging
collection DOAJ
language English
format Article
sources DOAJ
author Surender Rajasekaran
Mark Pressler
Jessica L. Parker
Alex Scales
Nicholas J. Andersen
Anthony Olivero
John R. Ballard
Robert McGough
spellingShingle Surender Rajasekaran
Mark Pressler
Jessica L. Parker
Alex Scales
Nicholas J. Andersen
Anthony Olivero
John R. Ballard
Robert McGough
Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
Healthcare
hemodynamics
monitored anesthesia care
perfusion
propofol
thermal imaging
author_facet Surender Rajasekaran
Mark Pressler
Jessica L. Parker
Alex Scales
Nicholas J. Andersen
Anthony Olivero
John R. Ballard
Robert McGough
author_sort Surender Rajasekaran
title Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
title_short Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
title_full Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
title_fullStr Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
title_full_unstemmed Quantifying and Trending the Thermal Signal as an Index of Perfusion in Patients Sedated with Propofol
title_sort quantifying and trending the thermal signal as an index of perfusion in patients sedated with propofol
publisher MDPI AG
series Healthcare
issn 2227-9032
publishDate 2018-07-01
description 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.
topic hemodynamics
monitored anesthesia care
perfusion
propofol
thermal imaging
url http://www.mdpi.com/2227-9032/6/3/87
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