Measure ID

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

Measure Type
Available for Provider Feedback

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

Measure Time Period

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
Success Criteria

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

Other Measure Details

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.

Risk Adjustment

Not applicable

Provider Attribution

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.

MPOG Concept Used

Temperature MPOG Concept IDs

  • 3050   Temp 1 - Unspecified Site
  • 3051   Temp 2 - Unspecified Site
  • 3052   Temp 1 - Monitoring Site
  • 3053   Temp 2 - Monitoring Site
  • 3031   Temperature - Temporal Artery
  • 3055   Temperature - Esophageal
  • 3056   Temperature - Blood
  • 3057   Temperature - Tympanic
  • 3058   Temperature - Bladder
  • 3059   Temperature - Nasopharyngeal
  • 3060   Temperature - Axillary
  • 3061   Temperature - Rectal
  • 3533   Temperature Route
  • 50174 Postoperative Vital Signs
  • 50191 Monitoring - Temperature probe placed
  • 50192 Monitoring - Temperature probe location/type
MPOG Phenotypes Used
  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
Measure Authors
Measure Author Institution
Meridith Wade MSN, RN  University of Michigan
Bishr Haydar, MD  University of Michigan
Jay Jeong  University of Michigan
MPOG Pediatric Subcommittee  


Measure Reviewer(s)
Next Review: 2026
 Date Reviewed  Reviewer  Institution  Summary  QC Vote


 Vikas O'Reilly-Shah, MD

 Jaques Scharoun, MD

 Seattle Children's

 Weill Cornell


Published Date: 04/2020
 Date  Criteria  Revision
 06/15/2023  Exclusion  Added GI Endoscopy exclusion; Added preop hypothermic/hyperthermic patient exclusion
 03/15/2022  Exclusion  Modified to use Procedure Type: Cardiac phenotype 
 03/25/2021   Exclusion   Modified to use Obstetric Anesthesia Technique phenotype; Case invalid if case end results before case start
 04/06/2020    Initial Publication