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Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
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Management of Body Temperature via the Respiratory Tract
Brian J Ring1, François Lellouche2,3, Robert Chatburn4
1Dr. Ring, Dr. Goodman, and Mr. Branson are affiliated with Division of Trauma Surgery and Critical Care, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Respiratory Care
|August 25, 2025
Summary
Mechanically ventilated patients face increased risks from hypothermia (low body temperature). Inhaling heated, humidified gases may help regulate body temperature, but more clinical evidence is needed.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Thermoregulation
Background:
- Hypothermia (core body temperature ≤35°C) increases morbidity and mortality in mechanically ventilated patients.
- Endotracheal intubation bypasses natural airway humidification, leading to heat and moisture loss.
- Existing airway humidification devices have controversial effectiveness for whole-body rewarming.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of airway-based thermoregulation.
- To assess the potential of inhaled heated, humidified gases for managing hypothermia in critical care.
Main Methods:
- This narrative review synthesizes current literature on airway-based thermoregulation.
- Evaluates existing and emerging technologies for heating and humidifying inhaled gases.
Main Results:
- The natural upper airway's role in conditioning inspired air is bypassed by intubation.
- Significant heat and moisture loss occurs, increasing hypothermia risk.
- Effectiveness of current airway warming strategies for rewarming is debated.
Conclusions:
- Airway-based thermoregulation via heated, humidified gases shows promise, particularly for specific scenarios like trauma care.
- Further robust clinical validation is essential to confirm efficacy and guide clinical practice.
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