Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia

Abstract Due to various factors such as anesthesia, the core body temperature of perioperative patients often fluctuates significantly. Ideal core temperature measurements are particularly needed during the perioperative period for early identification of hypothermia and malignant hyperthermia, and...

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Main Authors: Yan Liang, Jing-yan Wang, Xin-feng Shao, Ze-guang Wang, Mei-na Gao, Hao Liang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07314-w
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author Yan Liang
Jing-yan Wang
Xin-feng Shao
Ze-guang Wang
Mei-na Gao
Hao Liang
author_facet Yan Liang
Jing-yan Wang
Xin-feng Shao
Ze-guang Wang
Mei-na Gao
Hao Liang
author_sort Yan Liang
collection DOAJ
description Abstract Due to various factors such as anesthesia, the core body temperature of perioperative patients often fluctuates significantly. Ideal core temperature measurements are particularly needed during the perioperative period for early identification of hypothermia and malignant hyperthermia, and even to guide intraoperative temperature protection. This study aimed to evaluate the consistency of the optimized Zero-Heat-Flux (ZHF) thermometer with esophageal temperature monitoring under general anesthesia. Adult patients, classified as American Society of Anesthesiologists (ASA) I–III, who are scheduled for elective surgery will be enrolled in this study. Both esophageal and ZHF core temperature monitoring were measured simultaneously. The consistency and correlation between the two measurements were evaluated using Bland–Altman analysis, linear regression methods, and the percentage of differences within ± 0.5 °C. The sensitivity and specificity of the ZHF temperature in identifying hypothermia were further validated. Ninety patients with a total of 1035 pairs of measurements were analyzed. Bland–Altman analysis revealed a mean difference between ZHF temperature and esophageal temperature of 0.06 ± 0.26 °C, with 95% limits of agreement ranging from − 0.57 to 0.46 °C. 96.0% of the measurement differences were within ± 0.5 °C. The consistency correlation coefficient was 0.89 (95% CI 0.88–0.90). The sensitivity and specificity of ZHF temperature monitoring in diagnosing hypothermia were 0.86 and 0.91 respectively. The modified ZHF core temperature monitoring system demonstrates good accuracy and consistency with esophageal temperature monitoring during general anesthesia for surgery. ZHF temperature monitoring is highly reliable for diagnosing hypothermia, though further research is needed to evaluate its accuracy.
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spelling doaj-art-63b773aeb6eb434eab2d4724d58368172025-08-20T03:37:30ZengNature PortfolioScientific Reports2045-23222025-07-011511710.1038/s41598-025-07314-wAccuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesiaYan Liang0Jing-yan Wang1Xin-feng Shao2Ze-guang Wang3Mei-na Gao4Hao Liang5Department of Anesthesiology, Baoding No.1 Central HospitalDepartment of Otolaryngology, Affiliated Hospital of Hebei UniversityDepartment of Anesthesiology, Baoding No.1 Central HospitalDepartment of Anesthesiology, Baoding No.1 Central HospitalDepartment of Anesthesiology, Baoding No.1 Central HospitalDepartment of Anesthesiology, Baoding No.1 Central HospitalAbstract Due to various factors such as anesthesia, the core body temperature of perioperative patients often fluctuates significantly. Ideal core temperature measurements are particularly needed during the perioperative period for early identification of hypothermia and malignant hyperthermia, and even to guide intraoperative temperature protection. This study aimed to evaluate the consistency of the optimized Zero-Heat-Flux (ZHF) thermometer with esophageal temperature monitoring under general anesthesia. Adult patients, classified as American Society of Anesthesiologists (ASA) I–III, who are scheduled for elective surgery will be enrolled in this study. Both esophageal and ZHF core temperature monitoring were measured simultaneously. The consistency and correlation between the two measurements were evaluated using Bland–Altman analysis, linear regression methods, and the percentage of differences within ± 0.5 °C. The sensitivity and specificity of the ZHF temperature in identifying hypothermia were further validated. Ninety patients with a total of 1035 pairs of measurements were analyzed. Bland–Altman analysis revealed a mean difference between ZHF temperature and esophageal temperature of 0.06 ± 0.26 °C, with 95% limits of agreement ranging from − 0.57 to 0.46 °C. 96.0% of the measurement differences were within ± 0.5 °C. The consistency correlation coefficient was 0.89 (95% CI 0.88–0.90). The sensitivity and specificity of ZHF temperature monitoring in diagnosing hypothermia were 0.86 and 0.91 respectively. The modified ZHF core temperature monitoring system demonstrates good accuracy and consistency with esophageal temperature monitoring during general anesthesia for surgery. ZHF temperature monitoring is highly reliable for diagnosing hypothermia, though further research is needed to evaluate its accuracy.https://doi.org/10.1038/s41598-025-07314-wZero heat fluxHypothermiaCore temperature measurementMajor surgeryGeneral anesthesia
spellingShingle Yan Liang
Jing-yan Wang
Xin-feng Shao
Ze-guang Wang
Mei-na Gao
Hao Liang
Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
Scientific Reports
Zero heat flux
Hypothermia
Core temperature measurement
Major surgery
General anesthesia
title Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
title_full Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
title_fullStr Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
title_full_unstemmed Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
title_short Accuracy of improved zero heat flux core temperature monitoring in non-cardiac surgery for patients undergoing general anesthesia
title_sort accuracy of improved zero heat flux core temperature monitoring in non cardiac surgery for patients undergoing general anesthesia
topic Zero heat flux
Hypothermia
Core temperature measurement
Major surgery
General anesthesia
url https://doi.org/10.1038/s41598-025-07314-w
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