Percentage of cases receving general anesthesia that had at least one core temperature documented intraoperatively.

General anesthesia causes vasodilation thus redistributing body heat from the core to peripheries.  This redistribution can cause hypothermia.  Core temperatures outside the normal range pose significant risks to patients. Pediatric patients are more likely to develop perioperative hypothermia due to a high surface area to weight ratio and inability to regulate their own temperature.¹ Published research has correlated impaired wound healing, adverse cardiac events, altered drug metabolism, and coagulopathies with unplanned perioperative hypothermia. These adverse outcomes resulted in prolonged hospital stays and increased healthcare expenditures. The mortality rate is almost 20% higher only monitoring skin temperature rather than a core temperature for those who experience malignant hyperthermia during surgery.²  Core temperature measurements are less variable than skin temperature measurements and more accurately represent body temperature.^3-5

Anesthesia Start to Patient out of Room

All surgical patients receiving general anesthesia

• ASA 5 and 6 cases
• Cases with Neuraxial Anesthesia as the primary technique
• Cases with Regional Anesthesia as the primary technique
• Cases ≤ 30 minutes. *See other measure build details
• Labor Epidurals (as determined by the MPOG 'Obstetric Anesthesia Type' Phenotype results 'Labor Epidural' and 'Conversion (Labor Epidural Portion)')
• Obstetric Non-Operative Procedures (CPT: 01958)
• Procedure Type: MRI

*Cases where 'Measure End Time' precedes 'Measure Start Time' will be excluded and marked 'invalid'

Cases with at least one core temperature documented between Anesthesia Start and Patient out of Room. If not available then, Anesthesia End.

Core or Near Core Temperature Monitoring Includes:

• Pulmonary Artery Temperature
• Distal Esophageal Temperature
• Nasopharyngeal Temperature
• Tympanic Membrane Temperature
• Bladder Temperature
• Rectal Temperature
• Axillary Temperature (arm must be at patient side)
• Oral Temperature
• Zero-Flux Thermometer Temperature

Peripheral Temperatures (not compliant):

• Skin Temperature
• Temporal Artery Temperature

Temperature Artifact algorithm:

• Less than 32.0°C (89.6F)
• Greater than 40.0°C (104.0F)
• Any minute-to-minute jumps >0.5°C equivalent. 
  • Example: 0.125°C /15s, 0.25°C / 30s, 1°C / 2mins
• Conversion from F to C:    F=32 +9/5 (°C)

Note: If temperature site is not present in physiologic concept, will refer to intraop notes.

• 50191    Monitoring- Temperature Probe Placed
• 50192    Monitoring- Temperature Probe Location/Type
• 50174    Postoperative Vital Signs

Algorithm for determining Case Length:

• Start
  • Patient In Room. If not available, then
  • Induction End. If not available, then
  • Anesthesia Start
• End
  • Patient out of room. If not available, then
  • Anesthesia End

Not applicable.

Provider(s) present at Induction End. If not available, then

• Patient in Room. If not available, then
• Anesthesia Start

1. Kim P, Taghon T, Fetzer M, Tobias JD. Perioperative hypothermia in the pediatric population: a quality improvement project. American journal of medical quality : the official journal of the American College of Medical Quality. 2013;28(5):400-406.
2. Larach MG, Brandom BW, Allen GC, Gronert GA, Lehman EB. Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the North American malignant hyperthermia registry of the malignant hyperthermia association of the United States. Anesthesia and analgesia. 2014;119(6):1359-1366.
3. Sun Z, Honar H, Sessler DI, et al. Intraoperative core temperature patterns, transfusion requirement, and hospital duration in patients warmed with forced air. Anesthesiology. 2015;122(2):276-285.
4. Insler SR, Sessler DI. Perioperative thermoregulation and temperature monitoring. Anesthesiology clinics. 2006;24(4):823-837.
5. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology. 2008;109(2):318-338.