title: Comparison of esophageal, tympanic, and forehead skin temperatures in adult patients.
abstract: OBJECTIVE
  To compare esophageal, tympanic membrane, and forehead skin temperatures in patients undergoing elective surgeries.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Operating room and postanesthesia care unit of a tertiary care teaching hospital.
  
  
  METHODS
  40 adult ASA status I, II and III patients requiring anesthesia and surgery.
  
  
  METHODS
  Application of crystalline thermometry strips to the forehead of patients.
  
  
  RESULTS
  Concurrent forehead skin, tympanic membrane, and lower esophageal temperatures were measured and compared. The overall bias between esophageal and skin temperatures was 0.3 degrees C, between tympanic membrane and skin was 0.5 degrees C, and between esophageal and tympanic membrane was -0.1 degrees C The limits of agreement (precision) between esophageal and skin temperatures were: -1.64 degrees C to +2.32 degrees C, between esophageal and tympanic membrane were: -1.02 degrees C to +0.74, and between tympanic membrane and skin were: -1.48 degrees C to +2.52 degrees C. There was no significant relation between the change in skin temperature and change in esophageal temperature, whereas there was a weak linear relation between change in skin temperature and change in tympanic membrane temperature (y = -0.03 + 0.09, r = 0.12).
  
  
  CONCLUSIONS
  There was a lack of precision between the clinically accepted measurements (lower esophageal and tympanic membranes and the skin temperature measurement. The data suggest that forehead skin temperature is not interchangeable with standard core temperature measurements, and that sole reliance on the forehead skin measurement in the perioperative setting could adversely affect patient care.
authors.affiliation: Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: N
authors.initials: N
authors.lastname: Patel
authors.forename: C E
authors.initials: CE
authors.lastname: Smith
authors.forename: A C
authors.initials: AC
authors.lastname: Pinchak
authors.forename: J F
authors.initials: JF
authors.lastname: Hagen
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D001831:Body Temperature / Q000502:physiology*; D004432:Ear, Middle / Q000502:physiology*; D004947:Esophagus / Q000502:physiology*; D005546:Forehead; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D011446:Prospective Studies; D012881:Skin Temperature / Q000502:physiology*