Correlation of Nasopharyngeal (NP) and Lower Oesophageal (LO) Temperatures in Ventilated Children

NCT ID: NCT02201628

Last Updated: 2023-01-26

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

59 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-25

Study Completion Date

2014-12-16

Brief Summary

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Children lose heat under general anaesthesia, thus temperature is routinely monitored during anaesthesia for all but the shortest cases, and active warming can be used to prevent hypothermia and its resulting complications. Temperature can be measured at several sites dependent on the type of surgery and patient factors. Previously a temperature probe has been sited in the lower third of the oesophagus (swallowing tube) but it is difficult to accurately place this without an X-Ray. Consequently it is more common to use a temperature probe placed in the nasopharynx (where the nose and throat meet), when the child is anaesthetised.

However the investigators do not know if the temperature in the nasopharynx correlates well with the real core temperature or not.This prospective, unblinded, agreement study will seek to find an agreement of 2 methods to measure temperature in children undergoing general anaesthesia with a breathing tube that has a leak.

Detailed Description

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It is known that temperature in the lower third of the oesophagus correlates well with the gold standard of core temperature measurement, namely the temperature of blood in the heart. It is not known if oesophageal and nasopharyngeal temperatures correlate in children on a breathing machine via a tube with leak. If this study were to find a good correlation between oesophageal and nasopharyngeal temperature, this would allow clinicians to confidently use the more feasible nasopharyngeal temperature probes.

For this study 100 children will have both nasopharyngeal and oesophageal temperatures measured during general anaesthesia, both in the presence and absence of a leak around the endotracheal tube.

It is hypothesised that even in the presence of a leak, the temperature difference between the two methods will be less than 0.5 degrees centigrade.

Conditions

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Child

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Nasopharyngeal and oesophageal temperatures

An oesophageal and nasopharyngeal temperature probe will be placed and temperature will be measured at these site

Group Type EXPERIMENTAL

Nasopharyngeal and oesophageal temperature probes

Intervention Type DEVICE

Interventions

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Nasopharyngeal and oesophageal temperature probes

Intervention Type DEVICE

Other Intervention Names

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Covidien Mon-a-therm™ General Purpose Temperature Probe 400TM 90050

Eligibility Criteria

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Inclusion Criteria

* Patient requires general anaesthesia with endotracheal intubation for a procedure assisted by radiography (e.g. line insertion, line change).
* Patient requires chest radiograph for procedure.
* Expected anaesthetic time more than 30 minutes.

Exclusion Criteria

* No written parental written consent.
* Known oesophageal pathology (e.g. tracheo-oesophageal fistula, oesophageal strictures, oesophageal varices, oesophageal atresia).
* Known base of skull or midface fractures.
* Previous gastric bypass surgery or nasal surgery.
* Known coagulopathy.
* Previous alkaline ingestion.
* High aspiration risk.
* Significant respiratory co-morbidity requiring anticipated peak airway pressures \> 25 cm of water
* American Society Anaesthesiologists (ASA) grading 4 - 5.
* Tracheostomy in situ.
* Severe sepsis or septic shock or other other condition (such as bronchopulmonary fistula) that precludes use of tidal volume ventilation over 7 ml/kg.
* Known airway abnormalities (e.g. subglottic stenosis) that preclude placement of a MicroCuff® endotracheal tube.
* Oesophageal or nasopharyngeal probe contraindicated for reasons related to surgery / procedure.
Minimum Eligible Age

8 Months

Maximum Eligible Age

7 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Great Ormond Street Hospital for Children NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aarjan P Snoek, MBChB, FRCA

Role: PRINCIPAL_INVESTIGATOR

Great Ormond Street Hospital for Children NHS Foundation Trust

Helen V Hume-Smith, MBBS, FRCA

Role: PRINCIPAL_INVESTIGATOR

Great Ormond Street Hospital for Children NHS Foundation Trust

Emily Haberman, MBBS, FRCA

Role: PRINCIPAL_INVESTIGATOR

Great Ormond Street Hospital for Children NHS Foundation Trust

Locations

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Great Ormond Street Hospital for Children NHS Foundation Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Sessler DI. Complications and treatment of mild hypothermia. Anesthesiology. 2001 Aug;95(2):531-43. doi: 10.1097/00000542-200108000-00040. No abstract available.

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Evans DC, Doraiswamy VA, Prosciak MP, Silviera M, Seamon MJ, Rodriguez Funes V, Cipolla J, Wang CF, Kavuturu S, Torigian DA, Cook CH, Lindsey DE, Steinberg SM, Stawicki SP. Complications associated with pulmonary artery catheters: a comprehensive clinical review. Scand J Surg. 2009;98(4):199-208. doi: 10.1177/145749690909800402.

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Stone JG, Young WL, Smith CR, Solomon RA, Wald A, Ostapkovich N, Shrebnick DB. Do standard monitoring sites reflect true brain temperature when profound hypothermia is rapidly induced and reversed? Anesthesiology. 1995 Feb;82(2):344-51. doi: 10.1097/00000542-199502000-00004.

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Maxton FJ, Justin L, Gillies D. Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. J Adv Nurs. 2004 Jan;45(2):214-22. doi: 10.1046/j.1365-2648.2003.02883.x.

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Whitby JD, Dunkin LJ. Cerebral, oesophageal and nasopharyngeal temperatures. Br J Anaesth. 1971 Jul;43(7):673-6. doi: 10.1093/bja/43.7.673. No abstract available.

Reference Type BACKGROUND
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Litman RS, Maxwell LG. Cuffed versus uncuffed endotracheal tubes in pediatric anesthesia: the debate should finally end. Anesthesiology. 2013 Mar;118(3):500-1. doi: 10.1097/ALN.0b013e318282cc8f. No abstract available.

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Strobel CT, Byrne WJ, Ament ME, Euler AR. Correlation of esophageal lengths in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr. 1979 Jan;94(1):81-4. doi: 10.1016/s0022-3476(79)80361-3. No abstract available.

Reference Type BACKGROUND
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Ramsay JG, Ralley FE, Whalley DG, DelliColli P, Wynands JE. Site of temperature monitoring and prediction of afterdrop after open heart surgery. Can Anaesth Soc J. 1985 Nov;32(6):607-12. doi: 10.1007/BF03011406.

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Muravchick S. Deep body thermometry during general anesthesia. Anesthesiology. 1983 Mar;58(3):271-5. doi: 10.1097/00000542-198303000-00014. No abstract available.

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Wass CT, Long TR, Deschamps C. Entrapment of a nasopharyngeal temperature probe: an unusual complication during an apparently uneventful elective revision laparoscopic Nissen fundoplication. Dis Esophagus. 2010 Jan;23(1):33-5. doi: 10.1111/j.1442-2050.2009.00968.x. Epub 2009 Apr 15.

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Whitby JD, Dunkin LJ. Temperature differences in the oesophagus. The effects of intubation and ventilation. Br J Anaesth. 1969 Jul;41(7):615-8. doi: 10.1093/bja/41.7.615. No abstract available.

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Taylor C, Subaiya L, Corsino D. Pediatric cuffed endotracheal tubes: an evolution of care. Ochsner J. 2011 Spring;11(1):52-6.

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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https://www.nice.org.uk/guidance/cg65/update/CG65/documents/perioperative-hypothermia-inadvertent-guideline-full-guideline-part-12

National Institute for Health and Clinical Excellence. The management of inadvertent perioperative hypothermia in adults: full guideline

Other Identifiers

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14SG04

Identifier Type: -

Identifier Source: org_study_id

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