iThermonitor: A Wearable Non-Invasive High-Precision Alternative to Traditional Temperature Monitoring in Thoracoscopic Surgery of Lateral Decubitus Position

Purpose: In thoracoscopic surgery, temperature monitoring is essential but traditionally relies on invasive methods such as esophageal or rectal thermometry, which can lead to local mucosal damage and patient discomfort. This clinical trial evaluates the iThermonitor, a non-invasive, wireless, wearable axillary temperature monitoring device, as a potential alternative to traditional invasive methods, aiming to enhance patient preference and comfort by offering a non-invasive option that minimizes procedural discomfort while maintaining clinical precision. Patients and methods: We enrolled 80 adult patients scheduled for thoracoscopic surgery under general anesthesia between December 1, 2023, to May 31, 2024. The iThermonitor was used to measure axillary temperature, while lower esophageal temperature served as the reference standard. Temperature readings were recorded every 3 minutes. The primary outcome was the accuracy of the iThermonitor compared to lower esophageal temperature. Results: Analysis of 3536 temperature pairs showed the iThermonitor demonstrated high accuracy, with 93.96% of readings within ±0.5°C of the esophageal probe (95% CI: 91.94%–95.85%). The Pearson correlation coefficient was 0.75 ( P < 0.0001), and the concordance correlation coefficient was 0.69. The ATE/LER analysis indicated 94.3% of data points fell within the ATE zone (±0.5°C), with none in the LER zone (>1.5°C). The device showed strong predictive value for hypothermia (<36.0°C) with an AUC of 0.876. Notably, the esophageal probe exhibited bloodstaining in 73.8% of cases, whereas the iThermonitor caused only transient skin redness in 45% of patients, resolving completely postoperatively. Conclusion: The iThermonitor is a reliable and accurate non-invasive alternative to traditional invasive temperature monitoring methods in thoracoscopic surgery. It effectively detects perioperative hypothermia and offers significant patient-centered benefits, including enhanced comfort and safety. These findings support the potential of the iThermonitor to improve patient preference and adherence in clinical practice.