Core Temperature by Noninvasive Method vs Invasive Method in Infants and Young Children

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Core Temperature by Noninvasive Method vs Invasive Method in Infants and Young Children

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Context: Temperature is a vital parameter for monitoring under anesthesia. Induction of anesthesia leads to impairment of thermoregulatory center and results in redistribution of body heat from core to periphery. Hypothermia especially in children may results in increased morbidity and mortality. Sites of measurement of core body temperature are invasive and are not easily accesible. The purpose of this study is to evaluate the performance of skin temperature probe applied over the carotid artery in comparison to the nasopharyngeal, axillary, forehead temperature recordings. So that a better, safe and appropriate alternative to invasive temperature monitoring in pediatric age group can be used. Aim: To compare core temperature measured with invasive nasopharyngeal probe and noninvasive surface temperature measured with probe over axilla, forehead and skin over carotid artery. Settings and Design: The present study was a prospective, randomized and comparative study. We included 150 patients of age between 1 month and 60 months of ASA Grade 1 and 2, posted for elective abdominal and inguinoscrotal surgeries lasting more than 1 hour. Methods and Materials: Patients were randomly divided in 3 groups with 50 patients in each group. Group 1: Axillary vs nasopharyngeal temperature. Group 2: Forehead vs nasopharyngeal temperature. Group 3: Skin over carotid artery vs nasopharyngeal temperature. Standard General Anesthesia protocol was followed in all patients. We evaluated differences by monitoring and comparing invasive and noninvasive methods of temperature monitoring at above sites. Statistical analysis used: Software named statistical package for the social sciences (SPSS version 21.0, IBM Corporation, USA) for MS Windows. Results: Temperature noted throughout the surgery in Group 1 i.e. Axillary temperature v/s nasopharynx, temperature and we found that axillary temperature was lower by 1–1.5°C than nasopharynx temperature which was statistically significant (p-value being <0.05). Whereas in Group 2 i.e. Forehead temperature was lower by 2–3°C than nasopharynx temperature which was also statistically significant (p-value being < 0.05). However, in Group 3 we found that the temperature at skin over carotid artery (noninvasive) was almost equivalent to temperature at nasopharynx (invasive) with minimum difference of 0.2–0.3°C (p-value being >0.05), which was statistically not significant. This shows that temperature on skin over carotid artery almost equals to core, i.e. nasopharyngeal temperature in paediatric patients. Conclusions: We conclude that instead of using conventional invasive method of temperature monitoring, we can use equally reliable method of monitoring i.e. skin over carotid which is noninvasive, easily accessible with higher accuracy of estimating near core temperature.

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