Percentage of pediatric patients < 18 years old who have a median core/near core body temperature > 36C (96.8F) during the procedure.

Core temperatures outside the normal range pose significant risks to patients. Perioperative hypothermia is defined as a core temperature less than 36 degrees Celsius by both the National Institute of Health and Clinical Excellence and the American Heart Association. It is not uncommon for a patient’s core temperature to drop during surgery due to anesthetic induced peripheral vasodilation, exposure of skin during the surgical prep or impaired heat distribution. 

Pediatric patients are more likely to develop perioperative hypothermia due to a high surface area to weight ratio and the inability to regulate their own temperature as nonshivering thermogenesis which is impaired by general anesthesia. Perioperative hypothermia can result in multiple adverse effects including surgical site infections, cardiovascular events, impaired wound healing and increased hospital length of stay. Such adverse effects are prevented through maintenance of normothermia intraoperatively.^1-3

Patient In Room to Patient out of Room

Pediatric patients requiring anesthesia care

• Age ≥ 18 years 
• ASA 5 and 6 including Organ Procurement (CPT: 01990)
• Cases ≤ 30 minutes duration between measure start to measure end
• Cases without a core or near core temperature route documented
• Cases where patient is hypothermic (< 35.5C) or hyperthermic ( > 38C) preoperatively
• MAC cases (determined by Anesthesia Technique: Sedation) 
• Procedure Types
  • Cardiac cases (determined by Procedure Type: Cardiac value codes > 0)
  • MRI only procedures
  • Endoscopy and ERCP without another procedure
  • Unlisted Anesthesia procedure (CPT: 01999)
  • Labor Epidurals (determined by Obstetric Anesthesia Type value codes: 3 & 6 including obstetric non-operative procedures - CPT: 01958)

The median core or near core temperature intraoperatively is not less than 36 degrees Celsius (96.8F) 

Algorithm for determining Measure Start/End Times

Measure Start Time

1. Patient In Room. If not then, 
2. Induction Start. If not then,
3. Induction End. If not then, 
4. Surgery Start. If not then,
5. Anesthesia Start

Measure End Time

1. Patient out of Room. If not then, 
2. Surgery End. If not then
3. Anesthesia End

• Instances where there are two temperature monitoring methods, the average of both temperature values is used to determine the value for a single minute. 
• Conversion from C to F: F= 32 +9/5 (°C) 

Artifact Logic:

• Step 1: Exclude all Temperature values that are < 32C and > 40C
• Step 2: Apply artifact to exclude minute-to-minute values ≥ 0.5 C difference in temperature.
  • Example: If Temp B at 0801 is ≥ 0.5 C higher or lower than Temp A at 0800, then exclude Temp B
• Step 3: Exclude first 5 minutes of temperature monitoring to account for probe warming
  • minute-to-minute: exclude first 5 values
  • 5 minute intervals: exclude the first value
• Step 4: Calculate Median of remaining temperature values 

*This measure will include valid MPOG cases defined by the Is Valid Case phenotype.

Not applicable

Provider(s) present for longest duration of the case per staff role. In the event that two or more providers in the same class are signed in for the same duration, all providers signed in for the longest duration will be attributed.

1. Mutchnick I, Thatikunta M, Braun J, et al. Protocol-driven prevention of perioperative hypothermia in the pediatric neurosurgical population. J Neurosurg Pediatr. February 2020:1-7.
2. Pearce B, Christensen R, Voepel-Lewis T. Perioperative Hypothermia in the Pediatric Population: Prevalence, Risk Factors and Outcomes. Journal of Anesthesia & Clinical Research. 2010;01(01). doi:10.4172/2155-6148.1000102
3. Walker S, Amin R, Arca MJ, Datta A. Effects of Intraoperative Temperatures on Postoperative Infections in Infants and Neonates. J Pediatr Surg. October 2019. doi:10.1016/j.jpedsurg.2019.09.060