Optimal Positioning of Nasopharyngeal Temperature Probes in Infants and Children: A Prospective Cohort Study.

Autor:	Zhong JW; From the University of Texas Southwestern Medical Center and Children's Health of Dallas, Dallas, Texas., Sessler DI; Department of Outcome Research, Anesthesiology Institute, Cleveland Clinic; Cleveland, Ohio., Mao G; Department of Outcome Research, Anesthesiology Institute, Cleveland Clinic; Cleveland, Ohio., Jerome A; From the University of Texas Southwestern Medical Center and Children's Health of Dallas, Dallas, Texas., Chandran N; From the University of Texas Southwestern Medical Center and Children's Health of Dallas, Dallas, Texas., Szmuk P; From the University of Texas Southwestern Medical Center and Children's Health of Dallas, Dallas, Texas.; Outcome Research Consortium, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2023 May 01; Vol. 136 (5), pp. 986-991. Date of Electronic Publication: 2022 Nov 29.
DOI:	10.1213/ANE.0000000000006312
Abstrakt:	Background: The nasopharynx is an easily accessible core-temperature monitoring site, but insufficient or excessive nasopharyngeal probe insertion can underestimate core temperature. Our goal was to estimate optimal nasopharyngeal probe insertion depth as a function of age. Methods: We enrolled 157 pediatric patients who had noncardiac surgery with endotracheal intubation in 5 groups: (1) newborn to 6 months old, (2) infants 7 months to 1 year old, (3) children 13 to 23 months old, (4) children 2 to 5 years old, and (5) children 6 to 12 years old. A reference esophageal temperature probe was inserted at an appropriate depth based on each patient's height. A nasopharyngeal temperature probe was inserted from the naris at 10 cm in newborn and infants, 15 cm in children aged 1 to 5 years old, and 20 cm in children who were 6 years or older. The study nasopharyngeal probes were withdrawn 1, 2.5, or 2 cm (depending on age) 10 times at 5-minute intervals. Optimal probe insertion distances were defined by limits of agreement (LOAs) between nasopharyngeal and esophageal temperatures <0.5 °C. Results: Optimal nasopharyngeal temperature probe position ranged from 6 to 10 cm in infants up to 6 months old, 7 to 8 cm in infants 7 to 12 months old, 7.5 to 12 cm in children 13 to 23 months old, and 10 to 12 cm in children aged 6 years and older. The 95% LOAs were <0.5 °C for all age categories except the 2- to 5-year-old group where the limits extended from -0.67 °C to 0.52 °C at 9 cm. At the optimal position within each age range, the bias (average nasopharyngeal-to-esophageal temperature difference) was ≤0.1 °C. Conclusions: Nasopharyngeal thermometers accurately measure core temperature, but only when probes are inserted a proper distance, which varies with age. As with much in pediatrics, nasopharyngeal thermometer insertion depths should be age appropriate. Competing Interests: Conflicts of Interest: See Disclosures at the end of the article. (Copyright © 2022 International Anesthesia Research Society.)
Databáze:	MEDLINE
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