Temperature monitoring with zero-heat-flux technology in neurosurgical patients

  • Matthias Menzel
  • Anselm BräuerEmail author
Letter to the Editor

Dear Editor,

With great interest and enthusiasm we read the interesting article of Pesonen et al. [1] recently published in the journal about the measurement of core temperature with the new non-invasive zero-heat-flux thermometer (3M Bair-Hugger). Although the device has been validated in many patient groups undergoing cardiac surgery [2, 3], vascular surgery [3], gynecological and trauma surgery [4], abdominal surgery [5] and during intensive care [6] it had not yet been validated in patients undergoing neurosurgery. Therefore the authors work is valuable because the measurement of the zero-heat-flux thermometer can be disturbed in many ways in patients undergoing neurosurgical procedures.

Because the temperature sensor is located directly near the operative field the measurements may be influenced by washing and draping, the heat coming from the operating room lights or the drilling of the bone [7]. Furthermore craniotomy is associated with detachment of the brain from the cranium...


Core temperature monitoring Brain temperature Bladder temperature Zero-heat flux temperature measurement 


Compliance with ethical standards

Conflict of interest

MM is a member of the advisory board of 3M Europe and has received consulting fees and speaker honorarium from 3M Germany. AB is a member of the advisory board of 3M Europe and has received consulting fees and speaker honorarium from 3M Germany, 3M Europe and 3M Asia Pacific and 37 Company Netherlands.


  1. 1.
    Pesonen E, Silvasti-Lundell M, Niemi TT, Kivisaari R, Hernesniemi J, Mäkinen MT. (2019) The focus of temperature monitoring with zero-heat-flux technology (3M Bair-Hugger)—a clinical study with patients undergoing craniotomy. J Clin Monit Comp 32Google Scholar
  2. 2.
    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;119:543–9.CrossRefGoogle Scholar
  3. 3.
    Mäkinen MT, Pesonen A, Jousela I, Päivärinta J, Poikajärvi S, Albäck A, Salminen US, Pesonen E. Novel zero-heat-flux deep body temperature measurement in lower extremity vascular and cardiac surgery. J Cardiothorac Vasc Anesth. 2016;30:973–8.CrossRefGoogle Scholar
  4. 4.
    Iden T, Horn EP, Bein B, Böhm R, Beese J, Höcker J. Intraoperative temperature monitoring with zero heat flux technology (3M SpotOn sensor) in comparison with sublingual and nasopharyngeal temperature: An observational study. Eur J Anaesthesiol. 2015;32:387–91.CrossRefGoogle Scholar
  5. 5.
    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;35:825–30.CrossRefGoogle Scholar
  6. 6.
    Dahyot-Fizelier C, Lamarche S, Kerforne T, Benard T, Giraud B, Bellier R, Carise E, Frasca D, Mimoz O. Accuracy of zero-heat-flux cutaneous temperature in intensive care adults. Crit Care Med. 2017;45:e715–7.CrossRefGoogle Scholar
  7. 7.
    Schuhmann MU, Suhr DF, v.Gösseln HH, Bräuer A, Jantzen JP, Samii M. Local brain surface temperature compared to temperatures measured at standard extracranial monitoring sites during posterior fossa surgery. J Neurosurg Anesthesiol. 1999;11:90–5.CrossRefGoogle Scholar
  8. 8.
    Soukup J, Rieger A, Holz C, Miko I, Nemeth N, Menzel M. Temperature gradient between brain tissue and arterial blood mirrors the flow-metabolism relationship in uninjured brain: an experimental study. Acta Anaesthesiol Scand. 2007;51:872–9.CrossRefGoogle Scholar
  9. 9.
    Camboni D, Philipp A, Schebesch KM, Schmid C. Accuracy of core temperature measurement in deep hypothermic circulatory arrest. Interact Cardiovasc Thorac Surg. 2008;7:922–4.CrossRefGoogle Scholar
  10. 10.
    Henker RA, Brown SD, Marion DW. Comparison of brain temperature with bladder and rectal temperatures in adults with severe head injury. Neurosurgery. 1998;42:1071–5.CrossRefGoogle Scholar
  11. 11.
    Whitby JD, Dunkin LJ. Cerebral,oesophageal and nasopharyngeal temperatures. Br J Anaesth. 1971;43:673–6.CrossRefGoogle Scholar
  12. 12.
    Rossi S, Zanier ER, Mauri I, Columbo A, Stocchetti N. Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71:448–54.CrossRefGoogle Scholar
  13. 13.
    Rumana CS, Gopinath SP, Uzura M, Valadka AB, Robertson CS. Brain temperature exceeds systemic temperature in head-injured patients. Crit Care Med. 1998;26:562–7.CrossRefGoogle Scholar
  14. 14.
    Weisend MP, Feeney DM. The relationship between traumatic brain injury-induced changes in brain temperature and behavioral and anatomic outcome. J Neurosurg. 1994;80:120–32.CrossRefGoogle Scholar
  15. 15.
    Neeraj B. (2009) Hyperthermia and fever control in brain injury. Crit Care Med 37: 250–257.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical CareKlinikum WolfsburgWolfsburgGermany
  2. 2.Department of AnesthesiologyUniversity Hospital GöttingenGöttingenGermany

Personalised recommendations