Premium
Skin temperature over the carotid artery provides an accurate noninvasive estimation of core temperature in infants and young children during general anesthesia
Author(s) -
Jay Ollie,
MolgatSeon Yannick,
Chou Shirley,
Murto Kimmo
Publication year - 2013
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.12262
Subject(s) - medicine , axilla , carotid arteries , confidence interval , core temperature , core (optical fiber) , anesthesia , nuclear medicine , surgery , materials science , cancer , breast cancer , composite material
Summary Background The accurate measurement of core temperature is an essential aspect of intraoperative management in children. Invasive measurement sites are accurate but carry some health risks and cannot be used in certain patients. An accurate form of noninvasive thermometry is therefore needed. Our aim was to develop, and subsequently validate, separate models for estimating core temperature using different skin temperatures with an individualized correction factor. Methods Forty‐eight pediatric patients (0–36 months) undergoing elective surgery were separated into a modeling group ( MG , n = 28) and validation group ( VG , n = 20). Skin temperature was measured over the carotid artery ( T sk_carotid ), upper abdomen ( T sk_abd ), and axilla ( T sk_axilla ), while nasopharyngeal temperature ( T naso ) was measured as a reference. Results In the MG , derived models for estimating T naso were: T sk_carotid + 0.52; T sk_abd + (0.076[body mass] + 0.02); and T sk_axilla + (0.081[body mass]−0.66). After adjusting raw T sk_carotid, T sk_abd , and T sk_axilla values in the independent VG using these models, the mean bias (Predicted T naso – Actual T naso [with 95% confidence intervals]) was +0.03[+0.53, −0.50]°C, −0.05[+1.02, −1.07]°C, and −0.06[+1.21, −1.28°C], respectively. The percentage of values within ±0.5°C of T naso was 93.2%, 75.4%, and 66.1% for T sk_carotid, T sk_abd , and T sk_axilla , respectively. Sensitivity and specificity for detecting hypothermia ( T naso < 36.0°C) was 0.88 and 0.91 for T sk_carotid , 0.61 and 0.76 for T sk_abd , and 0.91 and 0.73 for T sk_axilla . Goodness‐of‐fit ( R 2 ) relative to the line‐of‐identity was 0.74 ( T sk_carotid ), 0.34 ( T sk_abd ), and 0.15 ( T sk_axilla ). Conclusions Skin temperature over the carotid artery, with a simple correction factor of +0.52°C, provides a viable noninvasive estimate of T naso in young children during elective surgery with a general anesthetic.