Therapeutic hypothermia and temperature management最新文献

{"title":"Early Prognostic Model for Predicting Adverse Outcomes in Neonates with Hypoxic-Ischemic Encephalopathy before Therapeutic Hypothermia.","authors":"Tomonori Kurimoto, Takuya Tokuhisa, Itaru Hayasaka, Hiroshi Ohashi, Tsuyoshi Yamamoto, Eiji Hirakawa, Takatsugu Maeda, Masato Kamitomo, Satoshi Ibara","doi":"10.1177/21537658251370513","DOIUrl":"10.1177/21537658251370513","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) affects 1.3-1.7 per 1000 live births and remains a major cause of neurodevelopmental impairment (NDI). Despite therapeutic hypothermia (TH), nearly half of infants with moderate to severe HIE experience death or NDI. Identifying early prognostic indicators before TH initiation is crucial for improving management and outcomes. We conducted a retrospective case-control study of 144 infants with HIE treated with TH at Kagoshima City Hospital (2000-2022); 100 underwent developmental evaluations at 18 months. Clinical parameters, including amplitude-integrated EEG (aEEG), Thompson scores, and resuscitation details, were analyzed. Logistic regression identified predictors of adverse outcomes: death, cerebral palsy, or developmental quotient <70. Univariate analysis revealed significant predictors, including low Apgar scores, low umbilical artery pH, aEEG abnormalities, high Thompson scores, and resuscitation details. Multivariate regression identified three independent predictors: aEEG abnormalities (adjusted odds ratios [aOR] 7.1, 95% confidence interval [CI]: 1.3-38.2), Thompson score ≥12 (aOR 5.4, 95% CI: 1.5-18.7), and chest compressions (aOR 31.6, 95% CI: 4.3-231.6). We developed and derived early prognostic model from these predictors, assigning +2 points for aEEG abnormalities, +2 points for a Thompson score ≥12, and +3 points for chest compressions. A total score ≥4 achieved high sensitivity (70.4%) and specificity (90.4%), with an area under the curve of 0.87 (95% CI: 0.77-0.94). The early prognostic model may serve as an effective tool for early risk stratification in neonates with HIE before TH initiation, supporting individualized treatment decisions. This score could help identify high-risk neonates who may benefit from additional neuroprotective strategies.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"116-122"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepping Out of the Cold: The Use of Surface Cooling Devices for Targeted Normothermia Temperature Management in Out of Hospital Cardiac Arrest Survivors-Common Pitfalls and Proposed Solutions.","authors":"Emma Ford, Josh Fox, James Williams","doi":"10.1177/21537658251378205","DOIUrl":"10.1177/21537658251378205","url":null,"abstract":"<p><p>The critical care unit at the University Hospital of Wales is a 38-bedded tertiary center. In 2023, the unit admitted 1251 unscheduled patients, of which 131 were out-of-hospital cardiac arrest (OOHCA) patients. The unit also participated in the Targeted Temperature Management 2 study and adopted the findings shortly after its publication in 2021. This gave us a unique exposure into the pitfalls associated with changing surface cooling protocols. The aim of this quality and safety initiative was to explore the causes of failure to comply with normothermic temperature targets in the OOHCA population, following a protocol change away from targeted therapeutic hypothermia. This article uses surface cooling data from OOHCA survivors. We discuss our findings from analysis of surface cooling data from 36 patients-13 pre-protocol change (targeted hypothermia) and 23 post-protocol change (targeted normothermia). Concerningly, following the change to targeted normothermia, rather than therapeutic hypothermia, the fever burden increased from an average of 2 to12 hours per patient. To address this problem, we reviewed the data and identified several causes of this failure. These failures included the failure to start the therapy at the selected trigger point, the interruption of therapy, inadequate pad sizing, and the failure to select the correct protocol. Surface cooling pitfalls are not commonly discussed in the literature, and therefore there remains a risk that units may overlook them, either when transitioning between protocols or when continuing with an ongoing surface cooling device. With evidence suggesting that pyrexia contributes to poorer outcomes, it is of vital importance that staff are aware of any potential pitfalls of surface cooling devices to mitigate unnecessary fever burden.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"123-129"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Thermal Blanket on Patients' Vital Signs, Shivering Level, Chill Status, and Thermal Comfort Perception in the Preoperative and Postoperative Periods.","authors":"İpek Köse Tosunöz, Evşen Nazik, Gülay İpek Çoban","doi":"10.1177/21537658251371364","DOIUrl":"10.1177/21537658251371364","url":null,"abstract":"<p><p>This study aimed to determine the effects of the thermal blanket on patients' vital signs, shivering level, chill status, and thermal comfort perception in preoperative and postoperative periods. The study was designed as a randomized controlled trial and included 44 female patients who had undergone elective gynecological surgery in a hospital in the south of Turkey. The experimental group (<i>n</i> = 22) was warmed using the passive warming method via a thermal blanket, and the control group (<i>n</i> = 22) was administered routine care via a cotton pique. The data collection tools included the \"Patient Information Form,\" the \"Patient Follow-Up Form,\" the \"Shivering Level Diagnosis Form,\" and the \"Thermal Comfort Perception Scale.\" Patients were warmed passively before (at least 10 minutes) and after surgery (at least 60 minutes) with a thermal blanket or cotton pique according to their groups. Patients' vital signs and oxygen saturation were recorded during the preoperative and postoperative periods at 15-minute intervals. The patients' shivering levels were recorded at 15-minute intervals, and chill status and thermal comfort perceptions were recorded at 30-minute intervals during the postoperative period. The data obtained in the research were analyzed using the SPSS 24.0 program. There were no statistically significant differences between the vital signs and oxygen saturation of the intervention and control groups during the first 60 minutes after surgery. The shivering level and coldness of the control group were higher in the postoperative period, but the difference between the groups was not statistically significant. There were no statistical differences between the groups in the time to reach 36.0°C (<i>p</i> > 0.05). Thermal comfort perception scores during the first 90 minutes were significantly higher in the intervention group (<i>p</i> < 0.05). The thermal blanket is not superior to the cotton pique used in standard care in maintaining body temperature, but it is effective in increasing thermal comfort perception.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"130-138"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Temperature Management Strategies in Pediatric Patients with Return of Spontaneous Circulation after Out-of-Hospital Cardiac Arrest: A Grading of Recommendations, Assessment, Development, and Evaluation-Assessed Systematic Review and Meta-Analysis.","authors":"Mohammed Alsabri, Shree Rath, Ibrahim Kamal, Salma Tamer Abdelrahman, Mayam Mohamed Aziz, Eric Lusinski, Zena Saleh","doi":"10.1177/21537658251379156","DOIUrl":"10.1177/21537658251379156","url":null,"abstract":"<p><p>Out-of-hospital cardiac arrest (OHCA) in children is a rare but catastrophic event, often resulting in significant neurological injury. Targeted temperature management (TTM), including therapeutic hypothermia (TH), has been proposed as a neuroprotective strategy. This systematic review and meta-analysis aims to evaluate the effects of different TTM strategies on survival and neurological outcomes in pediatric patients after OHCA. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Pooled outcomes were synthesized using odds ratios (OR) with 95% confidence intervals (CI), and the certainty of evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach. A total of nine studies encompassing 2107 pediatric patients were included. TH was associated with significantly higher odds of survival (OR: 1.72; 95% CI: 1.36-2.18; <i>p</i> < 0.0001) and favorable neurological outcome (OR: 1.64; 95% CI: 1.16-2.33; <i>p</i> = 0.006) compared to normothermia. Subgroup analysis demonstrated greater survival benefit at 12 months and improved neurological outcomes at 6-12 months. There were no statistically significant differences between groups in blood lactate levels, odds of arrhythmia, culture-proven infections, or length of hospital stay. The certainty of evidence for most outcomes was graded as low due to the predominance of nonrandomized studies and imprecision. TH as a TTM strategy following pediatric OHCA may offer survival and neurological advantage, particularly at longer-term follow-up, without a significant increase in adverse events. However, the low certainty of evidence highlights the need for further high-quality randomized trials to inform clinical practice and optimize neuroprotective care in this vulnerable population.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"87-96"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryotherapy Is Effective in Nulliparous Women with Primary Dysmenorrhea: A Randomized Controlled Trial.","authors":"Borja Pérez Domínguez, Lucia Gonzalez-Ruiz, Sara Muñoz-Ibañez, Maria Blanco-Diaz, Esther Diaz-Mohedo","doi":"10.1089/ther.2025.0008","DOIUrl":"10.1089/ther.2025.0008","url":null,"abstract":"<p><p>Primary dysmenorrhea is a prevalent condition causing severe menstrual pain in nulliparous women, negatively impacting daily functioning and well-being. This randomized controlled trial investigated the efficacy of cryotherapy in alleviating pain and enhancing secondary outcomes such as sleep quality, quality of life, and physical activity. Fifty-eight nulliparous women were randomly assigned to a cryotherapy group or a control group. Pain intensity was measured using the Numeric Rating Scale, whereas secondary outcomes were evaluated with the Pittsburgh Sleep Quality Index, World Health Organization Quality of Life-Brief Version, and the International Physical Activity Questionnaire. Socioeconomic factors, including household income, education, and occupation, were also assessed. Cryotherapy significantly reduced pain intensity from a baseline of 7.1 ± 1.4 to 1.8 ± 1.7 (<i>p</i> < 0.001) compared with a modest reduction in the control group (5.9 ± 1.9-5.4 ± 2.1). Sleep quality improved more in the cryotherapy group (6.90 ± 3.0 to 5.03 ± 2.5) than in the control group (6.88 ± 3.6 to 5.68 ± 2.8). However, no statistically significant changes were observed in the quality of life or physical activity levels, likely because menstrual pain alone may not sufficiently influence these domains, which are affected by broader psychosocial and behavioral factors. These findings demonstrate that cryotherapy is a simple, cost-effective intervention for managing primary dysmenorrhea, providing substantial pain relief and modest improvements in sleep quality. Further research is recommended to evaluate its long-term benefits and potential for broader applications in menstrual health management.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"97-106"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy-Drift in Clinical Practice in Swiss Neonatal (Intensive Care) Units?","authors":"Charlotte Lengauer, Mark Adams, Barbara Brotschi, Michael Kleber, Vera Bernet, Maren Tomaske, Dirk Bassler, Beate Grass","doi":"10.1089/ther.2025.0019","DOIUrl":"10.1089/ther.2025.0019","url":null,"abstract":"<p><p>The objective of this study was to assess the adherence to inclusion criteria for therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to survey current attitudes on TH. This multicenter observational study therefore combined a retrospective analysis of the Swiss National Asphyxia and Cooling Register (2011-2023) and a prospective survey (2024) among neonatologists in the Canton of Zurich, Switzerland. A total of 456 neonates with HIE were registered in the Swiss National Asphyxia and Cooling Register in the Canton of Zurich, Switzerland, between 2011 and 2023. The rate of TH (52.6% [2011-2017] versus 52.0% [2018-2023]) as well as the incidence of off-protocol cooling remained stable over time (<i>p</i> = 0.614). The survey response rate was 69.5% (57/82). Difficulties with clinical grading of encephalopathy were identified. Subjectively, respondents considered themselves more generous to initiate TH. In conclusion, register data reflected good adherence to inclusion criteria for TH. The survey confirmed willingness to consider TH in milder HIE cases. However, there was no drift in clinical practice-yet?</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"107-115"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between D-Dimer Trends and Intravascular Temperature Management-Related Venous Thromboembolism after Cardiac Arrest: A Single-Center Observational Study.","authors":"Ryosuke Nobe, Kenichiro Ishida, Taku Sogabe, Mitsuo Ohnishi","doi":"10.1177/21537658261480396","DOIUrl":"https://doi.org/10.1177/21537658261480396","url":null,"abstract":"<p><p>Intravascular temperature management (IVTM) is widely used for temperature control after cardiac arrest, but its association with IVTM-related venous thromboembolism (VTE) remains clinically important. D-dimer is commonly used for VTE evaluation, although interpretation is challenging after cardiac arrest because coagulation and fibrinolytic abnormalities can elevate D-dimer values. We conducted a single-center retrospective cohort study of out-of-hospital cardiac arrest patients treated with IVTM between August 2021 and August 2024. D-dimer levels were measured daily for 7 days and reported in µg/mL D-dimer units. IVTM-related VTE diagnosed within 10 days after admission was identified from medical records. Delta D-dimer was defined as the increase from each baseline value on Days 1, 2, or 3 to the peak value within 7 days. Among 51 patients, 8 (15.7%) developed IVTM-related VTE; the median time to diagnosis was 5.5 days. Peak D-dimer was higher in patients with IVTM-related VTE than in those without IVTM-related VTE (56.0 vs. 17.4 µg/mL DDU). Delta D-dimer was associated with IVTM-related VTE in adjusted logistic regression models, with adjusted odds ratios ranging from 1.04 to 1.10 per 1 µg/mL increase. In post-cardiac arrest patients undergoing IVTM, increases in D-dimer from early-phase values to peak were associated with IVTM-related VTE. Serial D-dimer assessment may help identify patients who warrant targeted imaging when IVTM-related VTE is clinically suspected.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658261480396"},"PeriodicalIF":0.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Intraoperative Hypothermia in Pediatric Burn Surgery: A Single-Center University Hospital Experience.","authors":"Cengiz Sahutoglu, Geylani Ozok, Canan Bor","doi":"10.1177/21537658261474905","DOIUrl":"https://doi.org/10.1177/21537658261474905","url":null,"abstract":"<p><p>Burns are a significant cause of morbidity and mortality in children, ranking third among the causes of injury-related deaths. Maintaining body temperature in burn patients is challenging, with the literature reporting an incidence of hypothermia up to 60%. This study aimed to determine the incidence and independent risk factors of intraoperative hypothermia in pediatric burn surgery. This retrospective observational cohort study included pediatric burn patients who underwent surgery in the pediatric surgery operating room between January 2016 and December 2019, comprising 396 procedures. Hypothermia was defined as a decrease in body temperature to below 36°C. The patients were divided into two groups: Group I (body temperature below 36°C) and Group II (body temperature ≥ 36°C). The study included patients with a median age of 30 months (1-204), and 57.3% were male. The hypothermia group exhibited a higher burn degree (25.3% vs. 10.7%, <i>p</i> < 0.001) and a higher percentage (10 [2-65] vs 6 [2-60], <i>p</i> < 0.001). Hypothermia was significantly higher in patients with flame burns than in those with scald burns (<i>p</i> < 0.001) and higher in the intratracheal general anesthesia group than in the laryngeal mask and mask/sedation groups (<i>p</i> < 0.001). Multivariable logistic regression analysis demonstrated that female gender (odds ratio [OR]: 3.358, <i>p</i> = 0.013), higher American Society of Anesthesiologists (ASA) score (OR: 3.440, <i>p</i> = 0.032), presence of a flame burn (OR: 5.685, <i>p</i> = 0.003), and prolonged duration of anesthesia (OR: 1.011, <i>p</i> = 0.022) were all independent risk factors for hypothermia. In our patient cohort, a high rate of intraoperative hypothermia (38.9%) was identified in pediatric burn patients. Female gender, higher ASA score, presence of a flame burn, and prolonged duration of anesthesia were all independent risk factors for hypothermia.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658261474905"},"PeriodicalIF":0.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Transnasal Temperature Modulation: Efficacy and Safety of a Single-Nostril Cooling Device in Critically Ill Patients.","authors":"Melissa Wagner, Kenneth Dalton, Dave Peprah, Jason J Chang, H Alex Choi, Neeraj Badjatia","doi":"10.1177/21537658261468190","DOIUrl":"https://doi.org/10.1177/21537658261468190","url":null,"abstract":"<p><p>Effective temperature management in critically ill patients with cerebrovascular injuries is vital. A transnasal temperature modulation device (tnTMD) has shown promise in achieving normothermia, but challenges with its dual-nostril configuration limited its efficacy. This study evaluates the efficacy and safety of a single-nostril configuration and identifies the optimal flow rate for effective cooling. This was a prospective, multi-center, open-label study of temperature reduction to achieve normothermia utilizing a tnTMD. Thirty adult patients with ischemic or hemorrhagic stroke, seizure, or metabolic encephalopathy underwent cooling with the tnTMD. Ten patients were treated with the dual-nostril configuration for 8 hours at 60 L/min, and another 10 patients for 24 hours at the same flow rate. Ten patients were treated with the single-nostril configuration for 24 hours at incrementally escalating flow rates (30, 40, and 50 L/min). Core temperature, shivering, and adverse events were reported. The statistical analysis compared reductions in temperature and safety outcomes across flow rates in the single-nostril cohort. The analysis also compares efficacy data from the dual-nostril treatment with those from single-nostril treatments of the tnTMD. A total of 10 patients underwent single-nostril cooling. The 40 L/min flow rate achieved the most consistent normothermia within 4 hours, with reduced temperature burden over 24 hours compared with 30 L/min (<i>p</i> = 0.03). Cooling efficacy at 40 and 50 L/min was similar, but 40 L/min showed lower variance. Shivering occurred in three cases; however, no severe cases of shivering were observed. There were no severe adverse effects. The single-nostril device demonstrated efficacy comparable to that of the dual-nostril approach, with improved practicality. The tnTMD effectively achieved normothermia with a novel single-nostril design with an optimal flow rate of 40 L/min. Given its ease of use and benign safety profile, future research should explore its applicability in non-intubated patients and in longer-duration cooling intervention.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658261468190"},"PeriodicalIF":0.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Axillary Chest Skin Temperature Underestimates Core Temperature During Redistribution Hypothermia Following Spinal Anesthesia.","authors":"Bo-Hyun Sang, Soojeong Oh, Lime Kim, So Woon Ahn","doi":"10.1177/21537658261468177","DOIUrl":"https://doi.org/10.1177/21537658261468177","url":null,"abstract":"<p><p>Accurate temperature monitoring is essential for detecting perioperative hypothermia during spinal anesthesia, where rapid redistribution of body heat commonly occurs. Although zero-heat-flux (ZHF) thermometry has emerged as a noninvasive method for estimating core temperature, the reliability of chest skin temperature monitoring in this context remains unclear. In this prospective observational study, temperature measurements were obtained at 5-minute intervals using a forehead ZHF sensor, an infrared tympanic thermometer, and a non-axillary chest skin probe in patients undergoing orthopedic surgery under spinal anesthesia. Agreement between methods was evaluated using Bland-Altman analysis for repeated measurements, the proportion of paired measurements within ±0.5°C, and Lin's concordance correlation coefficient. Ninety-nine patients completed the study. ZHF and tympanic temperatures showed good agreement, with a mean difference of 0.04 ± 0.35°C, limits of agreement from -0.63°C to 0.72°C, and 89% of paired measurements within ±0.5°C. In contrast, chest skin temperature demonstrated poor agreement with both ZHF and tympanic measurements. The mean difference between ZHF and chest skin temperature was 0.99 ± 1.11°C, with wide limits of agreement (-1.18°C to 3.17°C), and no measurements met the predefined ±0.5°C threshold. Similar discrepancies were observed when chest skin temperature was compared directly with tympanic temperature. These findings indicate that non-axillary chest skin temperature does not reliably reflect core temperature during redistribution hypothermia under spinal anesthesia and should not be used as a surrogate. ZHF thermometry showed substantially better agreement with tympanic temperature and may provide a more reliable noninvasive alternative for perioperative temperature monitoring.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658261468177"},"PeriodicalIF":0.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}