Anesth Pain Med.  2024 Oct;19(Suppl 1):S105-S112. 10.17085/apm.23150.

Feasibility and accuracy of pediatric core temperature measurement using an esophageal probe inserted through the gastric lumen of a second-generation supraglottic airway device: a prospective observational study

• Kim YJ
• Lee E
• Lee J
• Kim H
• Koh WU
• Ro YJ
• Kim HJ

• KMID: 2563591
• DOI: http://doi.org/10.17085/apm.23150

Abstract

Background
Accurate core temperature measurement in children is crucial; however, measuring esophageal temperature (TE) using a supraglottic airway device (SAD) can be challenging. Second-generation SADs, which have a gastric channel, can measure TE, and reduce gastric air volume. This study aimed to compare TE, measured using a probe inserted through the SAD gastric channel, with tympanic membrane (TTM) and forehead (TZHF) temperatures, measured using a zero-heat-flux cutaneous thermometer, with rectal temperature (TR).
Methods
Temperature was recorded at 10-min intervals from 10 min after probe insertion until completion of surgery. We performed an equivalence test to evaluate whether the TE, TTM, and TZHF were equivalent to TR, with a margin of 0.3°C. Additionally, intraclass correlation coefficients (ICC) were calculated to assess the reliability of TE and TR at each time point.
Results
We included 41 patients in the final analysis. In all patients, the esophageal probe was successfully inserted through the gastric channel of the SAD. When assessing agreement with TR as a reference, TE demonstrated equivalent results at all time points (P < 0.001 at 0, 10, 20, 30, and 40-min intervals and P = 0.018 at the 50-min interval), except at the completion of surgery (P = 0.697). TE also demonstrated good reliability with TR as a reference throughout the surgery (ICC > 0.75).
Conclusions
In children with SAD insertion, TE can be accurately and feasibly measured through the SAD’s gastric channel, making it suitable for routine application.

Keyword

Anesthesia; Pediatrics; Temperature; Esophagus; Rectum; Tympanic membrane

Figure

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  Fig. 1. ST probe with 9Fr used to measure esophageal temperature. ST: standard transverse.

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  Fig. 2. Flowchart of the study population in accordance with STROBE guidelines. STROBE: Strengthening the Reporting of Observational Studies in Epidemiology.

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  Fig. 3. Results of the Bland–Altman analysis comparing the temperatures recorded in the esophagus, tympanic membrane, and forehead with those recorded in the rectum. The solid line is the mean value of the difference, and the dashed line is the mean ± 1.96 standard deviation.

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