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Zero-heat-flux core temperature monitoring system: an observational secondary analysis to evaluate agreement with naso-/oropharyngeal probe during anesthesia

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Abstract

General anesthesia impairs thermoregulation and contributes to perioperative hypothermia; core body temperature monitoring is recommended during surgical procedures lasting > 30 min. Zero-heat-flux core body temperature measurement systems enable continuous non-invasive perioperative monitoring. During a previous trial evaluating the benefits of preoperative forced-air warming, intraoperative temperatures were measured with both a zero-heat-flux sensor and a standard naso-/oropharyngeal temperature probe. The aim of this secondary analysis is to evaluate their agreement. ASA I–III patients, scheduled for elective, non-cardiac surgery under general anesthesia, were enrolled. A zero-heat-flux sensor was placed on the participant’s forehead preoperatively. Following induction of anesthesia, a “clinical” temperature probe was placed in the nasopharynx or oropharynx at the anesthesiologist’s discretion. Temperature measurements from both sensors were recorded every 10 s. Agreement was analyzed using the Bland–Altman method, corrected for repeated measurements, and Lin’s concordance correlation coefficient, and compared with existing studies. Data were collected in 194 patients with a median (interquartile range) age of 60 (49–69) years, during surgical procedures lasting 120 (89–185) min. The zero-heat-flux measurements had a mean bias of − 0.05 °C (zero-heat-flux lower) with 95% limits of agreement within − 0.68 to + 0.58 °C. Lin’s concordance correlation coefficient was 0.823. The zero-heat-flux sensor demonstrated moderate agreement with the naso-/oropharyngeal temperature probe, which was not fully within the generally accepted ± 0.5 °C limit. This is consistent with previous studies. The zero-heat-flux system offers clinical utility for non-invasive and continuous core body temperature monitoring throughout the perioperative period using a single sensor.

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Acknowledgements

The authors would like to thank all the participating patients and anesthesiologists, the surgical and nursing teams in the operating room, as well as Aaron Lau, Nasim Lowlaavar and Alexandra German for their help with the data collection.

Funding

3M Canada sponsored the original randomized controlled trial, from which the data for this secondary was extracted, and provided the 3M Bair Hugger™ temperature monitoring systems and sensors.

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Authors and Affiliations

  1. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada

    Nicholas West, Erin Cooke, Richard N. Merchant & Matthias Görges

  2. Research Institute, BC Children’s Hospital, 950 West 28th Avenue, Rm V3-324, Vancouver, BC, V5Z 4H4, Canada

    Erin Cooke & Matthias Görges

  3. 3M Infection Prevention Division, 3M Corporation, St Paul, MN, USA

    Dan Morse

  4. Department of Anesthesia, Royal Columbian & Eagle Ridge Hospitals, Fraser Health, Vancouver, BC, Canada

    Richard N. Merchant

Authors
  1. Nicholas West
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  2. Erin Cooke
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  5. Matthias Görges
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Contributions

MG, EC, NW and RNM designed the study and obtained ethical approval to conduct the research. EC performed the data collection. DM and MG analyzed the data. NW and MG interpreted the findings and drafted the manuscript. All authors critically reviewed the manuscript, and read and approved the final version.

Corresponding author

Correspondence to Matthias Görges.

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Conflict of interest

Dan Morse is a salaried employee of 3M. The other authors have no conflicts of interest.

Research involving human participants

This study reports secondary analysis of data obtained in a previous trial that was conducted with research ethics board approval (Fraser Health Research Ethics Board, FHREB 2014-02).

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Written informed consent was obtained from all individual participants in the original study.

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West, N., Cooke, E., Morse, D. et al. Zero-heat-flux core temperature monitoring system: an observational secondary analysis to evaluate agreement with naso-/oropharyngeal probe during anesthesia. J Clin Monit Comput 34, 1121–1129 (2020). https://doi.org/10.1007/s10877-019-00411-y

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  • DOI: https://doi.org/10.1007/s10877-019-00411-y

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