What is the minimum time interval for reporting of intraoperative core body temperature measurements in pediatric anesthesia? A secondary analysis

J Clin Monit Comput. 2024 Dec 19. doi: 10.1007/s10877-024-01254-y. Online ahead of print.

Abstract

Given that perioperative normothermia represents a quality parameter in pediatric anesthesia, numerous studies have been conducted on temperature measurement, albeit with heterogeneous measurement intervals, ranging from 30 s to fifteen minutes. We aimed to determine the minimum time interval for reporting of intraoperative core body temperature across commonly used measurement intervals in children. Data were extracted from the records of 65 children who had participated in another clinical study and analyzed using a quasibinomial mixed linear model. Documented artifacts, like probe dislocations or at the end of anesthesia, were removed. Primary outcome was the respective probability of failing to detect a temperature change of 0.2 °C or more at any one measurement point at 30 s, one minute, two minutes, five minutes, ten minutes, and fifteen minutes, considering an expected probability of less than 5% to be acceptable. Secondary outcomes included the probabilities of failing to detect hypothermia (< 36.0 °C) and hyperthermia (> 38.0 °C). Following the removal of 4,909 exclusions, the remaining 222,366 timestamped measurements (representing just over 60 h of monitoring) were analyzed. The median measurement time was 45 min. The expected probabilities of failing to detect a temperature change of 0.2 °C or more were 0.2% [95%-CI 0.0-0.7], 0.5% [95%-CI 0.0-1.2], 1.5% [95%-CI 0.2-2.6], 4.8% [95%-CI 2.7-6.9], 22.4% [95%-CI 18.3-26.4], and 31.9% [95%-CI 27.3-36.4], respectively. Probabilities for the detection of hyperthermia (n = 9) were lower and omitted for hypothermia due to low prevalence (n = 1). In conclusion, the core body temperature should be reported at intervals of no more than five minutes to ensure the detection of any temperature change in normothermic ranges. Further studies should focus on hypothermic and hyperthermic ranges.

This study is a secondary analysis from a prospective cohort study, which was registered in the German Clinical Trials Register (DRKS00024703).

Keywords: Anesthesia; Body temperature; Pediatric; Temperature monitoring; Warming management.