{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T08:18:21Z","timestamp":1758874701095,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,12,16]],"date-time":"2015-12-16T00:00:00Z","timestamp":1450224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002736","name":"Covidien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002736","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004320","name":"Philips","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004320","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007018","name":"Kimberly-Clark Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007018","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A temperature probe placed in the lower third of the esophagus accurately reflects core temperature in anesthetized children. Temperature probes are commonly placed in the nasopharynx in children, but when utilizing an uncuffed endotracheal tube (<jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>) with a softly audible leak, ventilated gases from the trachea can escape upwards toward the nasopharynx, thereby potentially causing a cooling effect in the nasopharynx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to establish if nasopharyngeal and lower esophageal temperatures are in agreement in children undergoing general anesthesia, both in scenarios of ventilation with a cuffed <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> that has minimal or no leak (cuff up), as well as an <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> with leak (cuff down).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, crossover agreement study was performed on anesthetized children. Children were intubated with a MicroCuff<jats:sup>\u00ae<\/jats:sup> <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> and had temperature probes inserted into both the nasopharynx and lower esophagus. Under standardized ventilator and gas flow settings, temperatures were recorded with the <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> cuff inflated, and with the cuff deflated. Bland\u2013Altman plots were utilized to assess agreement of temperatures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients successfully completed this study. The mean difference between esophageal and nasopharyngeal temperature was found to be \u22120.03\u00b0C in the presence of minimal or no leak around the <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> (cuff up), with 95% limits of agreement (<jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>) of \u22120.22 to 0.15\u00b0C. The mean difference between esophageal and nasopharyngeal temperature was found to be 0.1\u00b0C when a larger leak existed around the <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> (cuff down), with <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content> of \u22120.31 to 0.51\u00b0C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nasopharyngeal temperature accurately reflects lower esophageal temperature when there is minimal or no <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> leak. When a larger <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content> leak is present, nasopharyngeal temperature is on average 0.1\u00b0C cooler than lower esophageal temperature. As the nasopharyngeal temperature probe site confers the advantage of simplicity of accurate placement compared to its esophageal counterpart, our findings support the use of nasopharyngeal temperature probes in children ventilated with both cuffed and uncuffed <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12830","type":"journal-article","created":{"date-parts":[[2015,12,16]],"date-time":"2015-12-16T06:30:00Z","timestamp":1450247400000},"page":"213-220","source":"Crossref","is-referenced-by-count":10,"title":["Agreement between lower esophageal and nasopharyngeal temperatures in children ventilated with an endotracheal tube with leak"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7822-7772","authenticated-orcid":false,"given":"Aarjan P.","family":"Snoek","sequence":"first","affiliation":[{"name":"Department of Anesthesia Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Saffer","sequence":"additional","affiliation":[{"name":"Department of Anesthesia King's College Hospital NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,12,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199605093341901"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06071-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540380041029"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)90466-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199712000-00009"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4172\/2155-6148.1000102"},{"key":"e_1_2_9_8_1","unstructured":"National Institute for Health and Clinical Excellence.The management of inadvertent perioperative hypothermia in adults: full guideline. 2008: Available at:http:\/\/www.nice.org.uk\/nicemedia\/live\/11962\/40429\/40429.pdf. 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