Accuracy of the non-invasive Tcore™ temperature monitoring system to measure body core temperature in abdominal surgery

  • Martin SoehleEmail author
  • Hilmar Dehne
  • Andreas Hoeft
  • Sven Zenker
Original Research


An accurate determination of body core temperature is crucial during surgery in order to avoid and treat hypothermia, which is associated with poor outcome. In a prospective observational study, we evaluated the suitability of the Tcore™ device (Drägerwerk AG & Co. KGaA, Lübeck, Germany)—a non-invasive thermometer—to accurately determine core body temperature. In patients undergoing surgery for ovarian cancer, core body temperature (CBT) was determined with the Tcore™ sensor attached to the forehead and compared with blood temperature (Tblood) as measured within the femoro-iliacal artery. Both temperatures were recorded every 10 s and the measurement error was calculated. 57,302 data pairs of CBT and Tblood were obtained in 22 patients. In a repeated-measurements version of the Bland and Altman test, a bias of − 0.02 °C and 95% limits of agreement of − 0.48 to 0.44 °C were calculated. In a population analysis, a median absolute error of 0 [− 0.1; + 0.1] °C, a bias of 0 [− 0.276; 0.271] % and an inaccuracy of 0.276 [0.274; 0.354] % was determined. Although the Tcore™ sensor was attached to the frontal skin, it provided an accurate measurement of core body temperature in the investigated intraoperative setting.


Anaesthesia Core body temperature Abdominal surgery Thermometer 



The complimentary provision of Tcore™ sensors by the manufacturer, Drägerwerk AG & Co.KGaA, Lübeck, Germany is gratefully acknowledged. The manuscript contains part of the doctoral thesis of HD.

Compliance with ethical standards

Conflict of interest

SZ has received consultancy fees and travel reimbursement from Drägerwerke AG & Co. KGaA in the past on projects unrelated to the investigated device. This study did not receive any support from the manufacturer other than provision of the device and disposable materials free of charge.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Sessler DI. Perioperative thermoregulation and heat balance. Lancet. 2016;387(10038):2655–64.CrossRefGoogle Scholar
  2. 2.
    Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71–7.CrossRefGoogle Scholar
  3. 3.
    Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334(19):1209–15.CrossRefGoogle Scholar
  4. 4.
    Krizanac D, Stratil P, Hoerburger D, Testori C, Wallmueller C, Schober A, Haugk M, Haller M, Behringer W, Herkner H, Sterz F, Holzer M. Femoro-iliacal artery versus pulmonary artery core temperature measurement during therapeutic hypothermia: an observational study. Resuscitation. 2013;84(6):805–9.CrossRefGoogle Scholar
  5. 5.
    Gunga H-C, Sandsund M, Reinertsen RE, Sattler F, Koch J. A non-invasive device to continuously determine heat strain in humans. J Therm Biol. 2008;33:297–307.CrossRefGoogle Scholar
  6. 6.
    Kimberger O, Thell R, Schuh M, Koch J, Sessler DI, Kurz A. Accuracy and precision of a novel non-invasive core thermometer. Br J Anaesth. 2009;103(2):226–31.CrossRefGoogle Scholar
  7. 7.
    Kimberger O, Saager L, Egan C, Sanchez IP, Dizili S, Koch J, Kurz A. The accuracy of a disposable noninvasive core thermometer. Can J Anaesth. 2013;60(12):1190–6.CrossRefGoogle Scholar
  8. 8.
    Klaschik S, Gehlen J, Neumann C, Keyver-Paik MD, Soehle M, Frede S, Velten M, Hoeft A, Hilbert T. Network of mediators for vascular inflammation and leakage is dysbalanced during cytoreductive surgery for late-stage ovarian cancer. Mediators Inflamm. 2019;2019:5263717.CrossRefGoogle Scholar
  9. 9.
    Zivanovic O, Abramian A, Kullmann M, Fuhrmann C, Coch C, Hoeller T, Ruehs H, Keyver-Paik MD, Rudlowski C, Weber S, Kiefer N, Poelcher ML, Thiesler T, Rostamzadeh B, Mallmann M, Schaefer N, Permantier M, Latten S, Kalff J, Thomale J, Jaehde U, Kuhn WC. HIPEC ROC I: a phase I study of cisplatin administered as hyperthermic intraoperative intraperitoneal chemoperfusion followed by postoperative intravenous platinum-based chemotherapy in patients with platinum-sensitive recurrent epithelial ovarian cancer. Int J Cancer. 2015;136(3):699–708.PubMedGoogle Scholar
  10. 10.
    Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571–82.CrossRefGoogle Scholar
  11. 11.
    Eshraghi Y, Nasr V, Parra-Sanchez I, Van Duren A, Botham M, Santoscoy T, Sessler DI. An evaluation of a zero-heat-flux cutaneous thermometer in cardiac surgical patients. Anesth Analg. 2014;119(3):543–9.CrossRefGoogle Scholar
  12. 12.
    Kimberger O, Cohen D, Illievich U, Lenhardt R. Temporal artery versus bladder thermometry during perioperative and intensive care unit monitoring. Anesth Analg. 2007;105(4):1042–7.CrossRefGoogle Scholar
  13. 13.
    Moran JL, Peter JV, Solomon PJ, Grealy B, Smith T, Ashforth W, Wake M, Peake SL, Peisach AR. Tympanic temperature measurements: are they reliable in the critically ill? A clinical study of measures of agreement. Crit Care Med. 2007;35(1):155–64.CrossRefGoogle Scholar
  14. 14.
    Gunga HC, Werner A, Stahn A, Steinach M, Schlabs T, Koralewski E, Kunz D, Belavy DL, Felsenberg D, Sattler F, Koch J. The Double Sensor-A non-invasive device to continuously monitor core temperature in humans on earth and in space. Respir Physiol Neurobiol. 2009;169(Suppl 1):63–8.CrossRefGoogle Scholar
  15. 15.
    Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008;109(2):318–38.CrossRefGoogle Scholar
  16. 16.
    Wartzek T, Muhlsteff J, Imhoff M. Temperature measurement. Biomed Tech (Berl). 2011;56(5):241–57.CrossRefGoogle Scholar
  17. 17.
    Sastre JA, Pascual MJ, Lopez T. Evaluation of the novel non-invasive zero-heat-flux Tcore thermometer in cardiac surgical patients. J Clin Monit Comput. 2019;33(1):165–72.CrossRefGoogle Scholar
  18. 18.
    Gomez-Romero FJ, Fernandez-Prada M, Fernandez-Suarez FE, Gutierrez-Gonzalez C, Estrada-Martinez M, Cachero-Martinez D, Suarez-Fernandez S, Garcia-Gonzalez N, Picatto-Hernandez MD, Martinez-Ortega C, Navarro-Gracia JF. Intra-operative temperature monitoring with two non-invasive devices (3M Spoton(R) and Dräger Tcore (R)) in comparison with the Swan--Ganz catheter. Cir Cardiov. 2019;26(4):191–6.Google Scholar
  19. 19.
    Boisson M, Alaux A, Kerforne T, Mimoz O, Debaene B, Dahyot-Fizelier C, Frasca D. Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: a prospective observational study. Eur J Anaesthesiol. 2018;35(11):825–30.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Anaesthesiology and Intensive Care MedicineUniversity Hospital BonnBonnGermany
  2. 2.Institute for Medical Informatics, Biometry, and EpidemiologyUniversity Hospital BonnBonnGermany
  3. 3.Staff Unit for Medical and Scientific Technology Development & CoordinationUniversity Hospital BonnBonnGermany

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