Cardiac arrest & resuscitation
Esophageal thermometry outperforms bladder and tympanic monitoring during targeted temperature management and shock in the intensive care unit (ICU)
Authors' conclusion
Esophageal thermometry is a highly reliable non-invasive surrogate for intravascular temperature. Conversely, bladder thermometry is susceptible to flow-dependent thermal inertia during shock and TTM. Meanwhile, tympanic measurements exhibit wide, hemodynamically-independent variability, rendering them unreliable for continuous monitoring.
Study context
- Population
- ICU patients receiving concurrent multi-site core temperature monitoring833 paired measurements
- Participants
- 22 patients
- Exposure
- Esophageal, bladder and tympanic thermometry vs intravascular temperature
- Outcome
- Accuracy (agreement with intravascular temperature: Bland-Altman and four-quadrant analyses)
- Follow-up
- Up to 72 h
Main finding
As reported in the abstract
Agreement with intravascular temperature
| Group | Value | Lin's CCC |
|---|---|---|
| Esophageal | bias 0.11 (95% LoA −0.19–0.41) °C | 0.957 |
Esophageal
Valuebias 0.11 (95% LoA −0.19–0.41) °C
Lin's CCC0.957
Observational data: associations, not effects.
Further findings
- Bladder thermal lag during targeted temperature management (TTM)
- 50.2% · trending concordance rate
- Bladder thermal lag during TTM — Lower CO increased core–bladder delay during cooling and re-warming (Spearman r)
- −0.42 (P < 0.05)
Tympanic error vs hemodynamics
- Correlation with cardiac index
- r = 0.08, P = 0.218
- Correlation with norepinephrine dosage
- r = 0.13, P = 0.052
Original publication
Esophageal thermometry outperforms bladder and tympanic monitoring during targeted temperature management and shock in the ICU. J Crit Care. Published 22 August 2026. doi:10.
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