A comparison of core temperature at different sites during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: A prospective observational study

BackgroundDuring cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, body temperature rapidly changes due to the hyperthermic agent. Depending on the method used, obtained values may vary, particularly during localized heating of the abdominal cavity. The primary aim of our study was to compare the effectiveness of core temperature monitoring techniques, nasopharyngeal temperature, zero-heat flux cutaneous thermometer device, and esophageal temperature, during hyperthermic intraperitoneal chemotherapy with cytoreductive surgery. MethodsBody temperature was measured using a zero-heat flux cutaneous thermometer device on the forehead and esophageal and nasopharyngeal probes throughout the surgery. Temperature differences were then calculated for each pair of measurements. We conducted an agreement analysis between the nasopharyngeal temperature and reference core temperature measurements using the 95% Bland-Altman limits of agreement for repeated measurement data. The proportion of all differences that were within 0.5 {degrees}C and repeated measures Lins concordance correlation coefficient were estimated. ResultsThe mean overall difference between nasopharyngeal and forehead temperature was -0.04 {+/-} 0.33 {degrees}C (95% limits of agreement: -0.69-0.62), and esophageal temperature was 0.02 {+/-} 0.35{degrees}C (95% limits of agreement: -0.66-0.71). The proportion of differences within 0.5 {degrees}C of TSpotOn was 0.03 (95% CI 0.01-0.04) and that of esophageal temperature was -0.06 (95% CI -0.08 to -0.05). The Lins concordance correlation coefficient of both were 0.94 (95% CI 0.93-0.94). After the hyperthermic intraperitoneal chemotherapy period, the temperatures rapidly decreased, followed by a noticeable rebound increase, particularly nasopharyngeal and forehead temperatures. The maximum difference between esophageal temperature and other temperatures was 1.5 {degrees}C. ConclusionsOur results reveal a strong correlation between nasopharyngeal, zero-heat flux cutaneous, and esophageal temperatures during surgery. However, consistent temperature differences with the esophageal thermometer were not observed. Post-hyperthermic intraperitoneal chemotherapy, rebound heating occurred at all sites, notably in the nasopharyngeal and zero-heat flux cutaneous areas.