Agreement between lower esophageal and nasopharyngeal temperatures in children ventilated with an endotracheal tube with leak

Snoek, Aarjan P.; Saffer, Emily

doi:10.1111/pan.12830

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…The second limitation concerns the positioning of the esophageal probe, which was done relying on the available anthropometric‐based insertion‐depth formulas. Unlike in the study of Snoek et al, intraoperative radiographic tip position confirmation was hardly justifiable considering that our study's population underwent procedures not requiring use of intraoperative radiography. Ultrasound confirmation would be ideal, but its use for this specific purpose is technically challenging.…”

Section: Discussionmentioning

confidence: 72%

Intra‐operative temperature monitoring with cutaneous zero‐heat‐ flux‐thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population

Carvalho

Najafi

Poelaert

2019

Pediatric Anesthesia

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Background: Maintenance of thermal homeostasis is of crucial importance in the anesthetized pediatric patient. Gold-standard methods for central core temperature measurement are however inappropriately invasive and impractical in daily practice.The SpotOn sensor uses zero-heat-flux thermometry technology and claims to bypass the invasiveness of classical methods and still accurately display central core temperatures. Up to date no formal analysis of this method in children has taken place. Aims:The primary objective was to assess the accuracy in comparison with esophageal temperature; the secondary objective concerned the safety of the SpotOn sensor in the pediatric patients. Methods: Fifty-four children aged 1-12 years with an American Society of Anesthesiology classification I or II scheduled to undergo elective surgical procedures under general anesthesia for a minimum of 30 minutes were included. Exclusion criteria included: fragile forehead skin, procedures impeding proper SpotOn placement, thoracoscopic or gastroesophageal procedures, coagulopathy, hemodynamic instability, or vasoactive medication use. After sevoflurane induction, an esophageal temperature probe was placed in the lower third of the esophagus, and a SpotOn sensor on the lateral forehead. Temperatures were recorded in pairs per 1 minute intervals. Temperatures were subjected to bias analysis with 0.5°C as the a priori established clinical significance cutoff. Results: Bland-Altman analysis revealed the two methods differed on average 0.14°C (95% limits of agreement: −0.39 to 0.66), with 89.5% of the differences being under 0.5°C. No significant differences could be found between the two methods for the established 0.5°C cutoff. Linear regression analysis determined the following linear regression equation: 0.837x + 5.86 (R 2 = 0.738). Lin's concordance correlation coefficient of 0.83 (95% CI: 0.81-0.84). No complications were observed with the use of the SpotOn sensor. Conclusion: SpotOn revealed itself as accurate as an esophageal temperature probe when estimating central core temperatures under ideal conditions and over a narrow range of temperatures. No adverse effects were observed with the use of the SpotOn sensor.

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Section: Discussionmentioning

confidence: 72%

Intra‐operative temperature monitoring with cutaneous zero‐heat‐ flux‐thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population

Carvalho

Najafi

Poelaert

2019

Pediatric Anesthesia

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“…The depth of the placement was calculated with the formula: Depth (cm) = (0.226 £ height) + 5. 13 A rectal temperature probe (Zhuhai Exsence Medical, China) was inserted 4 cm into the anus. The esophageal and rectal temperature probes were connected to a multiparameter patient monitor (Philips MX800, USA) to display readings continuously.…”

Section: Methodsmentioning

confidence: 99%

The Accuracy of a Wireless Axillary Thermometer for Core Temperature Monitoring in Pediatric Patients Having Noncardiac Surgery: An Observational Study

Ding

Han

et al. 2021

Journal of PeriAnesthesia Nursing

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A wireless and wearable axillary thermometer (iThermonitor) has been validated for perioperative core temperature monitoring in adults. The purpose of this study was to evaluate its accuracy in pediatrics having non−cardiac surgery. Design: Prospective observational study. Methods: From January 2019 to December 2019, 70 children aged younger than 14 years undergoing surgery in a tertiary hospital were selected. Pairs of esophageal temperatures (T Eso ), rectal temperatures (T Rec ), and axillary temperatures monitored by the iThermonitor (T iTh ) were collected every 5 min during surgery. Taking T Eso as reference, the bias between T Eso and T iTh and the proportion of bias within §0.5°C were calculated. Bland-Altman method was used to analyze the 95% of limits of agreement (LOA) between T iTh and T Eso . The same analyses were done for T Rec. Findings: A total of 2232 pairs of temperatures were collected. The bias (mean § SD) between T iTh and T Eso was -0.07°C § 0.25°C, and 95% LOA was -0.07°C § 0.50°C. The proportion of bias within §0.5°C accounted for 96% (95% Confidence Interval [CI], 92-98%). Higher bias and 95% LOA, and lower proportion of bias within § 0.5°C were found between T Rec and T Eso than those between T iTh and T Eso . Conclusion: During pediatric non−cardiac surgery, axillary temperature derived from iThermonitor is in good agreement with esophageal temperature and can be used as an alternative to core temperature.

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“…While nasopharyngeal probes should be inserted 10–20 cm in adults [ 67 ], insertion depth in children is unclear. The accuracy of nasopharyngeal probes is only minimally influenced by uncuffed endotracheal tubes [ 68 ]. However, both methods are still invasive, and can cause harm to the vulnerable mucosa, although the incidence of such events in children is unknown.…”

Section: Monitoring Of Core Temperaturementioning

confidence: 99%

Perioperative Hypothermia in Children

Nemeth

Miller

Bräuer

2021

IJERPH

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Background: First described by paediatric anaesthesiologists, perioperative hypothermia is one of the earliest reported side effects of general anaesthesia. Deviations from normothermia are associated with numerous complications and adverse outcomes, with infants and small children at the highest risk. Nowadays, maintenance of normothermia is an important quality metric in paediatric anaesthesia. Methods: This review is based on our collection of publications regarding perioperative hypothermia and was supplemented with pertinent publications from a MEDLINE literature search. Results: We provide an overview on perioperative hypothermia in the paediatric patient, including definition, history, incidence, development, monitoring, risk factors, and adverse events, and provide management recommendations for its prevention. We also summarize the side effects and complications of perioperative temperature management. Conclusions: Perioperative hypothermia is still common in paediatric patients and may be attributed to their vulnerable physiology, but also may result from insufficient perioperative warming. An effective perioperative warming strategy incorporates the maintenance of normothermia during transportation, active warming before induction of anaesthesia, active warming during anaesthesia and surgery, and accurate measurement of core temperature. Perioperative temperature management must also prevent hyperthermia in children.

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Agreement between lower esophageal and nasopharyngeal temperatures in children ventilated with an endotracheal tube with leak

Cited by 9 publications

References 29 publications

Intra‐operative temperature monitoring with cutaneous zero‐heat‐ flux‐thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population

Intra‐operative temperature monitoring with cutaneous zero‐heat‐ flux‐thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population

The Accuracy of a Wireless Axillary Thermometer for Core Temperature Monitoring in Pediatric Patients Having Noncardiac Surgery: An Observational Study

Perioperative Hypothermia in Children

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