Abstract
sBackgroundPatient outcomes are influenced by intraoperative temperature management. Oesophageal/pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. Many non-invasive temperature monitors have been studied. Only the TraxIt® Wearable Children’s Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor.MethodsWe conducted a prospective observational study of 100 patients receiving general anaesthesia for elective surgery. Patients were eligible for inclusion if they were ≥ 18 years old, were planned to have a general anaesthetic > 60 min during which no body cavity (chest or abdomen) would be opened. Patient temperature was measured with an oesophageal/pharyngeal thermistor probe and skin surface temperature monitors placed over the forehead, in the axilla, over the sternum, and behind the ear (over major vessels to the brain). Temperatures were recorded and then analysed using Altman-Bland plots. Pre-determined clinically relevant limits of agreement were set at −/+ 0.5 °C.ResultsFrom the 100 patients we collected 500 data points for each monitor with an average monitoring time of 102 min (30–300 min) across a range of surgical procedures. None of the skin surface temperature monitors achieved the pre-determined limits of agreement and results were impacted by the use of a forced air warmer.ConclusionThe TraxIt® Wearable Children’s Underarm Thermometers are not suitable for temperature monitoring during general anaesthesia.
Highlights
Patient outcomes are influenced by intraoperative temperature management
Oesophageal and pharyngeal temperature probes are the standard of care for intraoperative temperature monitoring but are not well tolerated in awake patients [4]
An oesophageal/pharyngeal thermistor temperature probe was placed between 10 and 20 cm from the nares, as insertion to this depth provides temperatures comparable to distal oesophageal temperatures and acted as a reference temperature [5]. This thermistor probe was not calibrated outside of the mandated yearly maintenance. This thermistor probe is the standard of care for temperature monitoring while under general anaesthesia at our institution (i.e. Is routinely inserted to monitor temperature whilst patients are under general anaesthesia)
Summary
Oesophageal/ pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. The TraxIt® Wearable Children’s Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor. Oesophageal and pharyngeal temperature probes are the standard of care for intraoperative temperature monitoring but are not well tolerated in awake patients [4]. An alternative temperature monitoring device available at our institution is the Traxit® Wearable Children’s Underarm Thermometer This thermometer utilises liquid crystals that have phase change properties when heated and is read using a dot matrix grid. The purported advantage of such a monitor is that it could be placed on the patient before anaesthesia while in the ward and could serve as the sole temperature monitor throughout the patient’s anaesthetic journey from ward to theatre and back again
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