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The esophageal temperature gradient in anesthetized children
E C Bloch1, B Ginsberg, R A Binner
1Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710.
Journal of Clinical Monitoring
|April 1, 1993
Summary
Anesthetic gas mixture temperature significantly impacts esophageal temperature readings in children. Optimal placement for accurate esophageal temperature monitoring is in the lower quarter of the esophagus.
Area of Science:
- Anesthesiology
- Pediatric critical care
- Medical instrumentation
Background:
- Accurate core body temperature monitoring is crucial in pediatric anesthesia.
- Esophageal temperature measurement is a common method, but influenced by external factors.
- The impact of anesthetic gas mixture (AGM) temperature on esophageal readings requires clarification.
Purpose of the Study:
- To investigate the effect of AGM temperature on esophageal temperature measurements in intubated children.
- To determine the optimal esophageal site for temperature sensor placement.
- To develop a reliable method for accurate esophageal temperature probe placement.
Main Methods:
- Utilized specialized esophageal temperature probes with multi-interval thermistors.
- Conducted measurements every 15 minutes for 120 minutes in anesthetized children.
- Compared readings between children receiving heated and unheated AGMs.
Main Results:
- Both AGM temperature and measurement site significantly affected esophageal temperature readings (p < 0.001).
- A significant interaction was observed between AGM temperature and measurement site (p < 0.007).
- The greatest effect of unheated AGMs was noted 3 cm distal to the endotracheal tube tip.
Conclusions:
- Accurate esophageal temperature monitoring requires careful thermistor placement in the lower quarter of the esophagus.
- A formula is provided for calculating optimal probe placement in pediatric patients.
- Acoustic criteria alone are unreliable for consistent and accurate esophageal thermometry.