Children Clinical Trial
Official title:
Paediatric Thermometry: Can the SpotOn™ Zero-Heat-Flux-Thermometry Sensor Accurately Measure Core Temperature in Children?
The present study aims to assess the accuracy of the SpotOn™ Zero-heat-flux-thermometry sensor in measuring core temperature in the paediatric population in the perioperative period.
Temperature regulation in the perioperative period is of primordial importance in paediatric
population - a particularly sensitive group for thermal variations.
In fact, infants lose a significantly high percentage of their core heat from skin
perspiration in comparison to adults (where it approximates roughly 10%). This percentage can
go up to 20% in premature infants and relates to the fact that cutaneous heat loss is "grosso
modo" proportional to body surface area.
This higher thermal vulnerability is aggravated during the perioperative period, where body
exposure to the cold operating room environment is increased, and where anaesthetic
interventions impair the compensatory mechanisms to the extent of being unable to
sufficiently increase heat production to compensate for hypothermia.
An alternative thermometry method called Zero-heat-flux was developed in the 1970's in an
attempt to compensate for the limitations of pure skin temperature, while maintaining its
practical character. It is based on the principle that the temperature 1-2 cm below skin
surface reasonably approximates core temperature. In order to measure it, it uses 4-layered
probe, with the following inside-out structure: patient temperature thermistor, insulating
foam layer, heating (flex) circuit, and insulating foam. A servo-controlled system actively
warms the probe circuit to the point where, theoretically, temperature equilibrium is
achieved between the skin and deeper structures and there is zero heat transfer to the
surrounding areas. This concept is commonly exemplified as the creation of a vertical
isothermal tunnel between the skin surface and lower dermal layers. Assuming a good tissue
perfusion, dermal temperature will reasonably approximate core temperature.
Although a systematic adult population validation is on its way, no data on the paediatric
patients exists.
Considering the practical and non-invasive character of this skin surface probe, as well as
the abovementioned thermal sensitivity concerns on the paediatric population, it seems that,
should the probe indeed prove to be accurate in this age range, it can definitely contribute
to the improvement of the perioperative temperature management in children.
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