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British Journal of Anaesthesia, Vol 81, Issue 2 171-175, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Accuracy and precision of "deep sternal" and tracheal temperatures at high- and low-fresh-gas flows

T. Matsukawa, M. Ozaki, D. I. Sessler, T. Nishiyama, M. Imamura and T. Kumazawa
Department of Anaesthesia, Yamanashi Medical University, Japan; Department of Anaesthesia, Tokyo Women's Medical College, Japan; Department of Anaesthesia and Perioperative Care, University of California, San Francisco, USA; Ludwig Boltzmann Institute for Clinical Anaesthesia and Intensive Care; Outcomes Research and Department of Anaesthesia and General Intensive Care, University of Vienna, Austria; Department of Anaesthesiology, The University of Tokyo, Faculty of Medicine, Tokyo, Japan

The accuracy of tracheal temperature as a measure of core temperature is relatively poor during high-flow ventilation (6 litre min-1 fresh- gas flow). It is unknown if accuracy improves when lower fresh-gas flow rates are used. We tested the hypothesis that tracheal temperature accuracy would improve with low-flow ventilation (1 litre min-1). We studied 20 ASA Physical Status I and II patients undergoing general anaesthesia for lower abdominal surgery. Deep body temperatures were measured at the middle of the sternum using a Coretemp "deep-tissue" thermometer. Tracheal temperatures were monitored from thermistors incorporated into the tracheal tube cuffs. Oesophageal temperatures were measured from thermocouples incorporated into stethoscopes positioned at the point of maximal heart sounds. Sternal temperature correlated reasonably well with distal oesophageal temperatures, both being within the 0.5 degree C cut-off for accuracy and precision. Tracheal temperatures were lower than oesophageal temperatures during both high- and low-flow ventilation. Tracheal temperatures were 0.7 degree C less during high-flow ventilation and 0.9 degree C less during low-flow ventilation. The precision in both cases was adequate. We conclude that tracheal temperatures were insufficiently accurate for routine clinical use, even when fresh- gas flow was restricted to 1 litre min-1. In contrast, the deep temperatures were sufficiently accurate and precise for routine clinical use.
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