Temperature measurement in critically ill orally intubated adults: A comparison of pulmonary artery core, tympanic, and oral methods

1999 ◽  
Vol 27 (10) ◽  
pp. 2188-2193 ◽  
Author(s):  
Karen K. Giuliano ◽  
Susan S. Scott ◽  
Sheila Elliot ◽  
Anthony J. Giuliano
Keyword(s):  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Critically Ill

Accuracy of infrared ear thermometry and other temperature methods in adults

1994 ◽  
Vol 3 (1) ◽  
pp. 40-54 ◽  
Author(s):  
RS Erickson ◽  
LT Meyer
Keyword(s):  
Critical Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
High Variability ◽  
External Factors ◽  
University Teaching ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Bladder Temperature ◽  
Pulmonary Artery Catheters

OBJECTIVE: To compare the accuracy of infrared ear-based temperature measurement in relation to thermometer, ear position, and other temperature methods, with pulmonary artery temperature as the reference. METHODS: Ear-based temperature measurements were made with four infrared thermometers, three in the core mode and two in the unadjusted mode, each with tug and no-tug techniques. Pulmonary artery, bladder (n = 21), and axillary temperatures were read after each ear-based measurement and oral temperature was measured once when possible (n = 32). Subjects consisted of a convenience sample of 50 patients with pulmonary artery catheters who were in adult critical care units of a university teaching hospital. RESULTS: Ear-based measurements correlated well with pulmonary artery temperature (r = .87 to .91), although closeness of agreement differed among thermometer-mode combinations (mean offsets = -0.7 to 0.5 degree C) and had moderately high variability between subjects (SD = +/- 0.5 degree C) with all instruments. Use of an ear tug either made no difference or resulted in slightly lower readings. Bladder temperature was nearly identical to pulmonary artery temperature values (r = .99, offset = 0.0 +/- 0.2 degree C). Oral readings were slightly lower (r = .78, offset = -0.2 degree C) and axillary readings much more so (r = .80 to .82, offset = -0.7 degree C); both were highly variable (SD = +/- 0.6 degree C) and affected by external factors. CONCLUSIONS: Infrared ear thermometry is useful for clinical temperature measurement as long as moderately high variability between patients is acceptable. Readings differ among thermometers, although several instruments provide values close to pulmonary artery temperature in adults. Readings are not higher with an ear tug. Bladder temperature substitutes well for pulmonary artery temperature, whereas oral and axillary values may be influenced by external factors in the critical care setting.

A comparison of five methods of temperature measurement in febrile intensive care patients

1995 ◽  
Vol 4 (4) ◽  
pp. 286-292 ◽  
Author(s):  
T Schmitz ◽  
N Bair ◽  
M Falk ◽  
C Levine
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Core Temperature ◽  
Rectal Temperature ◽  
False Negative ◽  
Negative Likelihood Ratio ◽  
Likelihood Ratios ◽  
Axillary Temperature ◽  
Intensive Care Patients

BACKGROUND: A clinically useful temperature measurement method should correlate well with the body's core temperature. Although previous investigators have studied temperature readings from different sites in hypothermic and normothermic patients, none have compared methods specifically in febrile patients. OBJECTIVE: To compare temperature measurement methods in febrile intensive care patients. METHODS: Temperature readings were obtained in rapid sequence from an electronic thermometer for oral and axillary temperature, rectal probe, infrared ear thermometer on "core" setting, and pulmonary artery catheter, approximately every hour during the day and every 4 hours at night. The sample consisted of 13 patients with pulmonary artery catheters and with temperatures of at least 37.8 degrees C. RESULTS: Rectal temperature correlated most closely with pulmonary artery temperature. Rectal temperature showed closest agreement with pulmonary artery temperature, followed by oral, ear-based, and axillary temperatures. Rectal and ear-based temperatures were most sensitive in detecting temperatures greater than 38.3 degrees C. Likelihood ratios for detecting hyperthermia were 5.32 for oral, 2.46 for rectal, and 1.97 for ear-based temperature. Rectal and ear-based temperatures had the lowest negative likelihood ratios, indicating the least chance of a false negative reading. Axillary temperature had a negative likelihood ratio of 0.86. CONCLUSIONS: Rectal temperature measurement correlates most closely with core temperature. If the rectal site is contraindicated, oral or ear-based temperatures are acceptable. Axillary temperature does not correlate well with pulmonary artery temperature. These results underscore the importance of consistency in method when establishing temperature trends, and of awareness of method when interpreting clinical data.

Extravascular lung water measurements and hemodynamic monitoring in the critically ill: bedside alternatives to the pulmonary artery catheter

2006 ◽  
Vol 291 (6) ◽  
pp. L1118-L1131 ◽  
Author(s):  
Warren Isakow ◽  
Daniel P. Schuster
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill ◽  
Extravascular Lung Water ◽  
Ejection Time ◽  
Lung Water ◽  
Descending Aorta ◽  
Hemodynamic Management ◽  
Flow Through

The recently completed Fluid and Catheter Treatment Trial conducted by the National Institutes of Health ARDSNetwork casts doubt on the value of routine pulmonary artery catheterization for hemodynamic management of the critically ill. Several alternatives are available, and, in this review, we evaluate the theoretical, validation, and empirical databases for two of these: transpulmonary thermodilution measurements (yielding estimates of cardiac output, intrathoracic blood volume, and extravascular lung water) that do not require a pulmonary artery catheter, and hemodynamic measurements (including estimates of cardiac output and ejection time, a variable sensitive to intravascular volume) obtained by esophageal Doppler analysis of blood flow through the descending aorta. We conclude that both deserve serious consideration as a means of acquiring useful hemodynamic data for managing shock and fluid resuscitation in the critically ill, especially in those with acute lung injury and pulmonary edema, but that additional study, including carefully performed, prospective clinical trials demonstrating outcome benefit, is needed.

Trends in the Use of Pulmonary Artery Catheter in Critically Ill Ventilated Patient

CHEST Journal ◽  
2003 ◽  
Vol 124 (4) ◽  
pp. 173S
Author(s):  
Gonzalo E. Gianella ◽  
Ganesan Murali ◽  
Michael Lippmann
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Critically Ill
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