Careful perioperative temperature management is important because it influences clinical outcomes. In pediatric patients, the esophageal temperature is the most accurate indicator of core temperature. However, it requires probe insertion into the body cavity, which is mildly invasive. Therefore, a non-invasive easily and continuously temperature monitor system is ideal. This study aimed to assess the accuracy of Temple Touch Pro™ (TTP), a non-invasive temperature monitoring using the heat flux technique, compared with esophageal (Tesoph) and rectal (Trect) temperature measurements in pediatric patients, especially in infants and toddlers. This single-center prospective observational study included 40 pediatric patients (< 3years old) who underwent elective non-cardiac surgery. The accuracy of TTP was analyzed using Bland-Altman analysis and compared with Tesoph or Trect temperature measurements. The error was within ± 0.5°C and was considered clinically acceptable. The bias ± precision between TTP and Tesoph was 0.09 ± 0.28°C, and 95% limits of agreement were - 0.48 to 0.65°C (error within ± 0.5°C: 94.0%). The bias ± precision between TTP and Trect was 0.41 ± 0.38°C and 95% limits of agreement were - 0.35 to 1.17°C (error within ± 0.5°C: 68.5%). In infants, bias ± precision with 95% limits of agreement were 0.10 ± 0.30°C with - 0.50 to 0.69°C (TTP vs. Tesoph) and 0.35 ± 0.29°C with - 0.23 to 0.92°C (TTP vs. Trect). Core temperature measurements using TTP in infants and toddlers were more accurate with Tesoph than with Trect. In the future, non-invasive TTP temperature monitoring will help perioperative temperature management in pediatric patients.
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