{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:27:48Z","timestamp":1785320868925,"version":"3.55.0"},"reference-count":48,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dr\u00e4ger Austria GmbH, 1230 Vienna, Austria"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Accurate temperature measurement is crucial for the perioperative management of pediatric patients, and non-invasive thermometry is necessary when invasive methods are infeasible. A prospective observational study was conducted on 57 patients undergoing elective surgery. Temperatures were measured using a dual-sensor heat-flux (DHF) thermometer (Tcore\u2122) and a rectal temperature probe (TRec), and the agreement between the two measurements was assessed. The DHF measurements showed a bias of +0.413 \u00b0C compared with those of the TRec. The limits of agreement were broader than the pre-defined \u00b10.5 \u00b0C range (\u22120.741 \u00b0C and +1.567 \u00b0C). Although the DHF sensors tended to overestimate the core temperature compared to the rectal measurements, an error grid analysis demonstrated that 95.81% of the DHF measurements would not have led to a wrong clinical decision, e.g., warming or cooling when not necessary. In conclusion, the low number of measurements that would have led to incorrect decisions suggests that the DHF sensor can be considered an option for continuous temperature measurement when more invasive methods are infeasible.<\/jats:p>","DOI":"10.3390\/jcm12227018","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T01:17:51Z","timestamp":1699579071000},"page":"7018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Accuracy of a Dual-Sensor Heat-Flux (DHF) Non-Invasive Core Temperature Sensor in Pediatric Patients Undergoing Surgery"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8329-6940","authenticated-orcid":false,"given":"Sebastian","family":"Zeiner","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-5424","authenticated-orcid":false,"given":"Markus","family":"Zadrazil","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Willschke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute Digital Health and Patient Safety (LBI DHPS), 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6153-6659","authenticated-orcid":false,"given":"Marion","family":"Wiegele","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-3780","authenticated-orcid":false,"given":"Peter","family":"Marhofer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7755-4445","authenticated-orcid":false,"given":"Fabian Peter","family":"Hammerle","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-9647","authenticated-orcid":false,"given":"Daniel","family":"Laxar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute Digital Health and Patient Safety (LBI DHPS), 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8010-7665","authenticated-orcid":false,"given":"Andreas","family":"Gleiss","sequence":"additional","affiliation":[{"name":"Institute of Clinical Biometrics, Center for Medical Data Science, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9766-1360","authenticated-orcid":false,"given":"Oliver","family":"Kimberger","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute Digital Health and Patient Safety (LBI DHPS), 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1016\/j.ajic.2020.01.002","article-title":"Perioperative body temperature maintenance and occurrence of surgical site infection: A systematic review with meta-analysis","volume":"48","author":"Poveda","year":"2020","journal-title":"Am. J. Infect. Control"},{"key":"ref_2","first-page":"12","article-title":"Inadvertent hypothermia and mortality in critically ill adults: Systematic review and meta-analysis","volume":"31","author":"Kiekkas","year":"2018","journal-title":"Aust. Crit. Care Off. J. Confed. Aust. Crit. Care Nurses"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1186\/s13054-016-1406-2","article-title":"Pyrexia: Aetiology in the ICU","volume":"20","author":"Niven","year":"2016","journal-title":"Crit. Care"},{"key":"ref_4","unstructured":"Torossian, A. (2023, August 02). AWMF S3 Guidelines on Preventing Inadvertant Perioperative Hypothermia. Deutsche Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin e.V. (DGAI). Available online: https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/001-018.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1111\/j.1365-2044.2009.06141_18.x","article-title":"NICE guidelines for inadvertent peri-operative hypothermia","volume":"64","author":"Radauceanu","year":"2009","journal-title":"Anaesthesia"},{"key":"ref_6","first-page":"945","article-title":"Regional heat loss in newborn infants. Part II. Heat loss in newborns with various diseases\u2014A method of assessing local metabolism and perfusion","volume":"68","author":"Simbruner","year":"1985","journal-title":"S. Afr. Med. J. Suid-Afr. Tydskr. Vir. Geneeskd."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Nemeth, M., Miller, C., and Br\u00e4uer, A. (2021). Perioperative Hypothermia in Children. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147541"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/pan.13531","article-title":"Integrating intraoperative physiology data into outcome analysis for the ACS Pediatric National Surgical Quality Improvement Program","volume":"29","author":"Afshar","year":"2019","journal-title":"Pediatr. Anesth."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1097\/00000542-200108000-00040","article-title":"Complications and Treatment of Mild Hypothermia","volume":"95","author":"Sessler","year":"2001","journal-title":"Anesthesiology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jpedsurg.2019.09.060","article-title":"Effects of intraoperative temperatures on postoperative infections in infants and neonates","volume":"55","author":"Walker","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1000102","DOI":"10.4172\/2155-6148.1000102","article-title":"Perioperative Hypothermia in the Pediatric Population: Prevalence, Risk Factors and Outcomes","volume":"1","author":"Pearce","year":"2010","journal-title":"J. Anesth. Clin. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2482","DOI":"10.1007\/s00268-020-05530-1","article-title":"Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery after Surgery (ERAS\u00ae) Society Recommendations","volume":"44","author":"Brindle","year":"2020","journal-title":"World J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1056\/NEJM199605093341901","article-title":"Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group","volume":"334","author":"Kurz","year":"1996","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/EJA.0000000000001322","article-title":"New-onset intra-operative hyperthermia in a large surgical patient population: A retrospective observational study","volume":"38","author":"Mittnacht","year":"2021","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_15","unstructured":"Torossian, A., Becke, K., Bein, B., Br\u00e4uer, A., Gantert, D., Greif, R., H\u00f6cker, J., Horn, E.P., Kimberger, O., and Klar, E. (2019). S3 Leitlinie \u201cVermeidung von perioperativer Hypothermie\u201d. Aktualisierung, 46. Available online: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/001-018l_S3_Vermeidung_perioperativer_Hypothermie_2019-08.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Mato, E., Varela-Aneiros, I., Abeleira-Pazos, M., Outumuro-Rial, M., Diz-Dios, P., Limeres-Posse, J., and Diniz-Freitas, M. (2022). Is It Useful to Determine the Temperature of Children for COVID-19 Screening in the Dental Setting?. J. Clin. Med., 11.","DOI":"10.3390\/jcm11040976"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1111\/pan.12244","article-title":"Perioperative temperature elevation: Not all hyperthermia is malignant hyperthermia","volume":"23","author":"Herlich","year":"2013","journal-title":"Pediatr. Anesth."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1097\/CCM.0b013e318169eda9","article-title":"Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America","volume":"36","author":"Barie","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/ALN.0000000000003481","article-title":"Perioperative Temperature Monitoring","volume":"134","author":"Sessler","year":"2021","journal-title":"Anesthesiology"},{"key":"ref_20","first-page":"543","article-title":"An evaluation of a zero-heat-flux cutaneous thermometer in cardiac surgical patients","volume":"119","author":"Eshraghi","year":"2014","journal-title":"Obstet. Anesth. Dig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/00000542-199703000-00012","article-title":"Influence of thermoregulatory vasomotion and ambient temperature variation on the accuracy of core-temperature estimates by cutaneous liquid-crystal thermometers","volume":"86","author":"Ikeda","year":"1997","journal-title":"Anesthesiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1042\/cs0440081","article-title":"A new method for monitoring deep body temperature from the skin surface","volume":"44","author":"Fox","year":"1973","journal-title":"Clin. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e0150759","DOI":"10.1371\/journal.pone.0150759","article-title":"Zero-heat-flux thermometry for non-invasive measurement of core body temperature in pigs","volume":"11","author":"Guschlbauer","year":"2016","journal-title":"PLoS ONE"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/EJA.0000000000000232","article-title":"Intraoperative temperature monitoring with zero heat flux technology (3M SpotOn sensor) in comparison with sublingual and nasopharyngeal temperature: An observational study","volume":"32","author":"Iden","year":"2015","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1088\/0967-3334\/32\/5\/005","article-title":"Non-invasive continuous core temperature measurement by zero heat flux","volume":"32","author":"Teunissen","year":"2011","journal-title":"Physiol. Meas."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1007\/s12630-013-0047-z","article-title":"The accuracy of a disposable noninvasive core thermometer","volume":"60","author":"Kimberger","year":"2013","journal-title":"Can. J. Anesth. Can. Anesth."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"21746","DOI":"10.1038\/s41598-020-78753-w","article-title":"Accuracy of zero-heat-flux thermometry and bladder temperature measurement in critically ill patients","volume":"10","author":"Fazliu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/bja\/aep134","article-title":"Accuracy and precision of a novel non-invasive core thermometer","volume":"103","author":"Kimberger","year":"2009","journal-title":"Br. J. Anaesth."},{"key":"ref_29","first-page":"103","article-title":"Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System","volume":"125","author":"Evron","year":"2017","journal-title":"Obstet. Anesth. Dig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1111\/pan.13653","article-title":"Intra-operative temperature monitoring with cutaneous zero-heat- flux-thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population","volume":"29","author":"Carvalho","year":"2019","journal-title":"Pediatr. Anesth."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/EJA.0000000000001796","article-title":"Evaluation of the non-invasive Temple Touch Pro temperature monitoring system compared with oesophageal temperature in paediatric anaesthesia (PETER PAN): A prospective observational study","volume":"40","author":"Nemeth","year":"2023","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_32","unstructured":"Draeger Medical Inc. (2023, August 15). Tcore System Core Temperature Sensor Instructions for Use. Available online: https:\/\/www.draeger.com\/de_at\/Home."},{"key":"ref_33","unstructured":"Smiths Medical (2006). ER400-9 ER400-12 Level I Esophageal\/Rectal Temperature Probe with 400 Series Thermistor Probe. Instructions for Use, Smiths Medical ASD Inc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/096228029900800204","article-title":"Measuring agreement in method comparison studies","volume":"8","author":"Bland","year":"1999","journal-title":"Stat. Methods Med. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1177\/0962280211402548","article-title":"Confidence interval estimation for the Bland-Altman limits of agreement with multiple observations per individual","volume":"22","author":"Zou","year":"2013","journal-title":"Stat. Methods Med. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/ALN.0b013e31817f6d76","article-title":"Temperature Monitoring and Perioperative Thermoregulation","volume":"109","author":"Sessler","year":"2008","journal-title":"Anesthesiology"},{"key":"ref_37","first-page":"89","article-title":"Let\u2019s Think Clinically Instead of Mathematically about Device Accuracy","volume":"113","author":"Morey","year":"2011","journal-title":"Obstet. Anesth. Dig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/S0140-6736(22)00560-8","article-title":"Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): A multicentre, parallel group, superiority trial","volume":"399","author":"Sessler","year":"2022","journal-title":"Lancet"},{"key":"ref_39","unstructured":"Reback, J., McKinney, W., Van Den Bossche, J., Augspurger, T., Cloud, P., Hawkins, S., Roeschke, M., Klein, A., Petersen, T., and She, C. (2023, July 21). Pandas-dev\/Pandas: Pandas 1.3.4. Zenodo. Available online: https:\/\/zenodo.org\/record\/5574486."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/j.jvca.2003.10.030","article-title":"Massive epistaxis after nasopharyngeal temperature probe insertion after cardiac surgery","volume":"18","author":"Sinha","year":"2004","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1055\/s-2000-12475","article-title":"Genauigkeit derBlasentemperaturmessungbei intraabdominellen Eingriffen","volume":"35","author":"Martin","year":"2000","journal-title":"AINS An\u00e4sthesiol. Intensiv. Notfallmed. Schmerzther."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Tsadok, I., Scheinowitz, M., Shpitzer, S.A., Ketko, I., Epstein, Y., and Yanovich, R. (2021). Assessing rectal temperature with a novel non-invasive sensor. J. Therm. Biol., 95.","DOI":"10.1016\/j.jtherbio.2020.102788"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10877-022-00851-z","article-title":"Evaluation of the Temple Touch ProTM noninvasive core-temperature monitoring system in 100 adults under general anesthesia: A prospective comparison with esophageal temperature","volume":"37","author":"Fazliu","year":"2023","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1007\/s00134-002-1619-5","article-title":"Temperature measurement in intensive care patients: Comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method","volume":"29","author":"Lefrant","year":"2003","journal-title":"Intensive Care Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/pan.12177","article-title":"Forced-air warming in infants and children","volume":"23","author":"Sessler","year":"2013","journal-title":"Pediatr. Anesth."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s10877-020-00609-5","article-title":"Intraoperative zero-heat-flux thermometry overestimates esophageal temperature by 0.26 \u00b0C: An observational study in 100 infants and young children","volume":"35","author":"Nemeth","year":"2021","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Aj\u010devi\u0107, M., Stella, A.B., Furlanis, G., Caruso, P., Naccarato, M., Accardo, A., and Manganotti, P. (2022). A Novel Non-Invasive Thermometer for Continuous Core Body Temperature: Comparison with Tympanic Temperature in an Acute Stroke Clinical Setting. Sensors, 22.","DOI":"10.3390\/s22134760"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lu, H., Aratake, S., Naito, H., Nogawa, M., Nemoto, T., Togawa, T., and Tanaka, S. (2023). Development of a Core Body Thermometer Applicable for High-Temperature Environment Based on the Zero-Heat-Flux Method. Sensors, 23.","DOI":"10.3390\/s23041970"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:20:43Z","timestamp":1760131243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/22\/7018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":48,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jcm12227018"],"URL":"https:\/\/doi.org\/10.3390\/jcm12227018","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]}}}