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Updated: May 31, 2025
Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Reliability of Tracheal Temperature as a Measurement of Core Body Temperature During Cardiac Surgery Using
Hyun-Uk Kang1, Sou-Hyun Lee2, Ji-Hyun Chin1
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Abstract:
Background: To compare tracheal temperature (TET) with nasopharyngeal temperature (TNP) in patients undergoing cardiac surgery using cardiopulmonary bypass (CPB). Methods: TET was measured using a thermistor in the cuff of an endotracheal tube and TNP was monitored using an esophageal stethoscope. Depending on the management of the CPB strategy, the operation was divided into four periods (pre-CPB, cooling, rewarming, and post-CPB). A Bland-Altman analysis was carried out to compare TET with TNP in each period. The concordance correlation coefficient for repeated measures analysis and various time lags was used to validate the time lag maximizing the concordance correlation coefficient between the two methods. Results: A total of 7191 pairs of temperature recordings acquired from 24 patients were included in the analysis. During steady normothermia, 81.7% (95% confidence interval [CI], 79.8-83.5%) of the pairs had a difference within ±0.5 °C, with a mean bias of -0.28 °C and limits of agreement (LOA) of -0.74 °C to 0.18 °C. The LOA during the cooling and rewarming phase of CPB were -1.13 °C to 0.51 °C and -0.91 °C to 1.29 °C, respectively. The mean bias and LOA throughout the entire operation were -0.10 °C and -0.98 °C to 0.77 °C, respectively. Throughout the entire operation, -2 min of time lag on TET maximized the concordance correlation coefficient (0.94 [95% CI, 0.92-0.96] to 0.95 [95% CI, 0.93-0.96]), indicating an earlier response of TET than TNP. Conclusions: TET could be an alternative to TNP during cardiac surgery using CPB.
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