Non-Invasive Monitoring of Core Body Temperature for Targeted Temperature Management in Post-Cardiac Arrest Care

Kyle Fiorini^{1

2}, Tanya Tamasi³, Justin Dorie³, Ahmed F Hegazy^{2

4}, Ting-Yim Lee^{5

6}, Marat Slessarev^{2

3

7}

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
² Division of Critical Care, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
³ Kidney Clinical Research Unit, Lawson Health Research Institute, London, ON, Canada.
⁴ Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, ON, Canada.
⁵ Department of Medical Imaging and Biophysics, Western University, London, ON, Canada.
⁶ Imaging Program, Lawson Health Research Institute, London, ON, Canada.
⁷ Brain and Mind Institute, Western University, London, ON, Canada.

PMID: 35492302
PMCID: PMC9043456
DOI: 10.3389/fmed.2022.810825

Non-Invasive Monitoring of Core Body Temperature for Targeted Temperature Management in Post-Cardiac Arrest Care

Kyle Fiorini et al. Front Med (Lausanne). 2022.

. 2022 Apr 13:9:810825.

doi: 10.3389/fmed.2022.810825. eCollection 2022.

Authors

Kyle Fiorini^{1

2}, Tanya Tamasi³, Justin Dorie³, Ahmed F Hegazy^{2

4}, Ting-Yim Lee^{5

6}, Marat Slessarev^{2

3

7}

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
² Division of Critical Care, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
³ Kidney Clinical Research Unit, Lawson Health Research Institute, London, ON, Canada.
⁴ Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, ON, Canada.
⁵ Department of Medical Imaging and Biophysics, Western University, London, ON, Canada.
⁶ Imaging Program, Lawson Health Research Institute, London, ON, Canada.
⁷ Brain and Mind Institute, Western University, London, ON, Canada.

PMID: 35492302
PMCID: PMC9043456
DOI: 10.3389/fmed.2022.810825

Abstract

Importance: Accurate monitoring of core body temperature is integral to targeted temperature management (TTM) following cardiac arrest. However, there are no reliable non-invasive methods for monitoring temperature during TTM.

Objectives: We compared the accuracy and precision of a novel non-invasive Zero-Heat-Flux Thermometer (SpotOn™) to a standard invasive esophageal probe in a cohort of patients undergoing TTM post-cardiac arrest.

Design setting and participants: We prospectively enrolled 20 patients undergoing post-cardiac arrest care in the intensive care units at the London Health Sciences Centre in London, Canada. A SpotOn™ probe was applied on each patient's forehead, while an esophageal temperature probe was inserted, and both temperature readings were recorded at 1-min intervals for the duration of TTM.

Main outcomes and measures: We compared the SpotOn™ and esophageal monitors using the Bland-Altman analysis and the Pearson correlation, with accuracy set as a primary outcome. Secondary outcomes included precision and correlation. Bias exceeding 0.1°C and limits of agreement exceeding 0.5°C were considered clinically important.

Results: Sixteen (80%) of patients had complete data used in the final analysis. The median (interquartile range) duration of recording was 38 (12-56) h. Compared to the esophageal probe, SpotOn™ had a bias of 0.06 ± 0.45°C and 95% limits of agreement of -0.83 to 0.95°C. The Pearson correlation coefficient was 0.97 (95% confidence interval 0.9663-0.9678), with a two-tailed p < 0.0001.

Conclusion and relevance: The SpotOn™ is an accurate method that may enable non-invasive monitoring of core body temperature during TTM, although its precision is slightly worse than the predefined 0.5°C when compared to invasive esophageal probe.

Keywords: brain injuries; critical care; heart arrest; hypothermia; induced; technology; thermometers.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 2**
Temperature measurement between SpotOn™ and an esophageal probe in a representative patient.

**Figure 3**
Bland-Altman analysis comparing SpotOn™ and the esophageal temperature probe.

**Figure 4**
Correlation between temperature measurement using SpotOn™ and the esophageal temperature probe.

**Figure 5**
Bland-Altman analysis comparing SpotOn™ and esophageal temperature probes in different temperature ranges, including deep hypothermia (<34°C), mild hypothermia (34–35.9°C), and normothermia (≥36°C).

See this image and copyright information in PMC

References

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Non-Invasive Monitoring of Core Body Temperature for Targeted Temperature Management in Post-Cardiac Arrest Care

Affiliations

Non-Invasive Monitoring of Core Body Temperature for Targeted Temperature Management in Post-Cardiac Arrest Care

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References