Comparison of Tracheal Versus Esophageal Temperatures During Laparoscopic Surgery

Overview

Journal Can J Anaesth

Specialty Anesthesiology

Date 2024 Mar 12

PMID 38468077

Authors

Eun Kyung Lee

Yu Jeong Bang

Jeayoun Kim

Hyun Joo Ahn

Affiliations

Soon will be listed here.

Abstract

Purpose: Recently, endotracheal tubes with an embedded temperature sensor in the inner surface of the tube cuff (temperature tracheal tubes) have been developed. We sought to assess whether temperature tracheal tubes show a good agreement with esophageal temperature probes during surgery.

Methods: We enrolled 40 patients who underwent laparoscopic surgery in an observational study. The tracheas of all patients were intubated with a temperature tracheal tube, and an esophageal temperature probe was inserted into the esophagus. Tracheal and esophageal temperatures were recorded at 15-min intervals until the end of surgery. Temperatures from both devices were analyzed using Bland-Altman analysis, four-quadrant plots, and polar plots.

Results: We analyzed 261 data points from 36 patients. Temperatures ranges were 34.2 °C to 36.6 °C for the tracheal temperature tube and 34.7 °C to 37.2 °C for the esophageal temperature probe. Bland-Altman analysis showed an acceptable agreement between the two devices, with an overall mean bias (95% limit of agreement) of -0.3 °C (-0.8 °C to 0.1 °C) and a percentage error of 3%; the trending ability (temperature changes over time) between the two devices showed a concordance rate of 94% in four-quadrant plot (cut-off ≥ 92%), but this was higher than the acceptable mean angular bias of 177° (cut-off < ± 5°) and radial limits of agreement of 52° (cut-off < ± 30°) in the polar plot. Bronchoscopy during extubation and patient interviews at six hours postoperatively revealed no serious injuries related to the use of the temperature tracheal tube.

Conclusion: The temperature tracheal tube showed an acceptable overall mean bias of -0.3 °C and a percentage error of 3%, but incompatible trending ability with the esophageal temperature probe.

Study Registration: cris.nih.go.kr (KCT0007265); 22 April 2022.

References

Sessler D . Perioperative Temperature Monitoring. Anesthesiology. 2020; 134(1):111-118. DOI: 10.1097/ALN.0000000000003481. View

Frank S, Fleisher L, Breslow M, Higgins M, Olson K, Kelly S . Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA. 1997; 277(14):1127-34. View

Kurz A, Sessler D, Lenhardt R . Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996; 334(19):1209-15. DOI: 10.1056/NEJM199605093341901. View

Rajagopalan S, Mascha E, Na J, Sessler D . The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2007; 108(1):71-7. DOI: 10.1097/01.anes.0000296719.73450.52. View

Lenhardt R, Marker E, Goll V, Tschernich H, Kurz A, Sessler D . Mild intraoperative hypothermia prolongs postanesthetic recovery. Anesthesiology. 1998; 87(6):1318-23. DOI: 10.1097/00000542-199712000-00009. View

Bindu B, Bindra A, Rath G . Temperature management under general anesthesia: Compulsion or option. J Anaesthesiol Clin Pharmacol. 2017; 33(3):306-316. PMC: 5672515. DOI: 10.4103/joacp.JOACP_334_16. View

Wang M, Singh A, Qureshi H, Leone A, Mascha E, Sessler D . Optimal Depth for Nasopharyngeal Temperature Probe Positioning. Anesth Analg. 2016; 122(5):1434-8. DOI: 10.1213/ANE.0000000000001213. View

Yamakage M, Kawana S, Watanabe H, Namiki A . The utility of tracheal temperature monitoring. Anesth Analg. 1993; 76(4):795-9. DOI: 10.1213/00000539-199304000-00020. View

Pasquier M, Paal P, Kosinski S, Brown D, Podsiadlo P, Darocha T . Esophageal Temperature Measurement. N Engl J Med. 2020; 383(16):e93. DOI: 10.1056/NEJMvcm1900481. View

10.

Abu-Gazala S, Donchin Y, Keidar A . Nasogastric tube, temperature probe, and bougie stapling during bariatric surgery: a multicenter survey. Surg Obes Relat Dis. 2011; 8(5):595-600. DOI: 10.1016/j.soard.2011.08.017. View

11.

Sun Y, Jia L, Yu W, Yu H, Sheng M, Du H . The changes of intraoperative body temperature in adult liver transplantation: A retrospective study. Hepatobiliary Pancreat Dis Int. 2018; 17(6):496-501. DOI: 10.1016/j.hbpd.2018.08.006. View

12.

Sessler D . Perioperative thermoregulation and heat balance. Lancet. 2016; 387(10038):2655-2664. DOI: 10.1016/S0140-6736(15)00981-2. View

13.

Lefrant J, MULLER L, de La Coussaye J, Benbabaali M, Lebris C, Zeitoun N . Temperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method. Intensive Care Med. 2003; 29(3):414-8. DOI: 10.1007/s00134-002-1619-5. View

14.

Erickson R, Kirklin S . Comparison of ear-based, bladder, oral, and axillary methods for core temperature measurement. Crit Care Med. 1993; 21(10):1528-34. DOI: 10.1097/00003246-199310000-00022. View

15.

Imaizumi H, Okada K, Namiki A, Nanba H, Ando T, Takahashi T . [Evaluation of the usefulness of bladder temperature monitoring during non-abdominal, upper and lower abdominal surgery]. Masui. 1987; 36(2):232-6. View

16.

Yang S, Cho H, Kim H . Comparison of tracheal temperature and core temperature measurement in living donor liver transplant recipients: a clinical comparative study. BMC Anesthesiol. 2022; 22(1):315. PMC: 9549662. DOI: 10.1186/s12871-022-01853-9. View

17.

Haugk M, Stratil P, Sterz F, Krizanac D, Testori C, Uray T . Temperature monitored on the cuff surface of an endotracheal tube reflects body temperature. Crit Care Med. 2010; 38(7):1569-73. DOI: 10.1097/CCM.0b013e3181e47a20. View

18.

Adnet F, Borron S, Racine S, Clemessy J, Fournier J, Plaisance P . The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology. 1998; 87(6):1290-7. DOI: 10.1097/00000542-199712000-00005. View

19.

Neckebroek M, Boldingh J, De Smet T, Struys M . Influence of Remifentanil on the Control Performance of the Bispectral Index Controlled Bayesian-Based Closed-Loop System for Propofol Administration. Anesth Analg. 2019; 130(6):1661-1669. DOI: 10.1213/ANE.0000000000004208. View

20.

Chan K, Chan M, Gin T . Mainstream vs. sidestream capnometry for prediction of arterial carbon dioxide tension during supine craniotomy. Anaesthesia. 2003; 58(2):149-55. DOI: 10.1046/j.1365-2044.2003.03035.x. View