Comparison of core temperature monitoring methods during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a prospective observational study.

BACKGROUND

During cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC), precise core temperature monitoring is critical for patient safety. This prospective study evaluated the agreement among three core temperature monitoring modalities: nasopharyngeal temperature (Tnaso), zero-heat flux cutaneous thermometer (TSpotOn), and oesophageal temperature (Teso).

METHODS

Temperatures were measured simultaneously; agreement between monitoring sites was assessed using Bland-Altman analysis for repeated measures including mean bias, 95% limits of agreement, and confidence intervals, alongside Lin's concordance correlation coefficient (LCCC). The proportion of paired differences within the clinically acceptable limit of 0.5 °C was reported.

RESULTS

The mean difference between Tnaso and TSpotOn was -0.04 ± 0.33 °C (95% limits: -0.69 to 0.62), and between Tnaso and Teso was 0.02 ± 0.35 °C (95% limits: -0.66 to 0.71), with LCCC for both comparisons at 0.94 (95% CI: 0.93-0.94), indicating substantial agreement. However, up to 14% of Teso pairs exceeded the 0.5 °C threshold, suggesting potential clinical relevance. Notable rapid temperature decline and subsequent rebound were observed post-HIPEC at Tnaso and TSpotOn sites.

CONCLUSION

All three monitoring methods correlated strongly overall, but Teso exhibited phase-dependent discrepancies, particularly after HIPEC. These findings support tailoring core temperature measurement site selection with attention to the target organ, especially in laparotomy-based HIPEC procedures.

TRIAL REGISTRATION: The study was registered in the clinical trials registry cris.nih.go.kr (Registration Number: KCT0003980).