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.

Temperature Measurement—Gold Standard

PEDIATRICS ◽  
1992 ◽  
Vol 90 (4) ◽  
pp. 649-649
Author(s):  
MARTIN E. WEISSE
Keyword(s):  
Temperature Measurement ◽  
Core Temperature ◽  
Conventional Method ◽  
Study Design ◽  
Rectal Temperature ◽  
Gold Standard ◽  
Relative Accuracy ◽  
Temperature Determination ◽  
Conventional Methods

To the Editor.— I would like to comment on the article by Freed and Fraley in the March 1992 issue of Pediatrics.1 I have no argument with their study design and in fact applaud them for using Altman and Bland's method of analysis. Their conclusions, as written, are correct, that the tympanic thermometer "is unreliable compared with conventional methods of temperature determination." The three issues that I would like to raise are: (1) the relative accuracy of rectal and tympanic temperatures in predicting core temperature, (2) rectal temperature as the "gold standard," and (3) axillary thermometry as an acceptable conventional method of clinical temperature.

Estimation of Pulmonary Artery Pressures in Intensive Care Patients Using Both Continuous and Pulsed Wave Doppler

2007 ◽  
Vol 16 ◽  
pp. S43
Author(s):  
P. Iyngkaran ◽  
R. Perry ◽  
A. Bersten ◽  
C.G. De Pasquale ◽  
D.P. Chew ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Intensive Care Patients ◽  
Pulsed Wave Doppler

Femoro-iliacal artery versus pulmonary artery core temperature measurement during therapeutic hypothermia: An observational study

Resuscitation ◽  
2013 ◽  
Vol 84 (6) ◽  
pp. 805-809 ◽  
Author(s):  
Danica Krizanac ◽  
Peter Stratil ◽  
David Hoerburger ◽  
Christoph Testori ◽  
Christian Wallmueller ◽  
...  
Keyword(s):  
Observational Study ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Therapeutic Hypothermia ◽  
Core Temperature

Pulmonary artery catheters for adult intensive care patients

2001 ◽  
Author(s):  
S Harvey ◽  
W Brampton ◽  
A Cooper ◽  
G Doig ◽  
K Rowan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Intensive Care Patients ◽  
Pulmonary Artery Catheters

Abstract P136: Tracheal Temperature for Monitoring Core Temperature during Mild Hypothermia in Pigs

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Danica Krizanac ◽  
Moritz Haugk ◽  
Wolfgang Weihs ◽  
Michael Holzer ◽  
Keywan Bayegan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Pulmonary Artery ◽  
Temperature Measurement ◽  
Core Temperature ◽  
Tracheal Tube ◽  
Mild Hypothermia ◽  
Temperature Monitoring ◽  
Surface Cooling ◽  
Significant Difference ◽  
Mean Differences

Purpose of the stud y: Early out-of-hospital induction of mild hypothermia after cardiac arrest needs an easy to use and accurate core temperature monitoring, which might be achievable with tracheal temperature measurement. The aim of the study was to evaluate which tracheal temperature site (Ttra) reflects best pulmonary artery temperature (Tpa) during the induction of mild hypothermia. Methods: Eight pigs (29 –38 kg) were anesthetized and intubated with a specially designed endotracheal tube with three temperature probes: Ttra1 was attached to the wall of the tube, 1 cm proximal to the cuff-balloon, without contact to the mucosa; Ttra2 and Ttra3 were placed on the cuff-balloon with tight contact to the mucosa, whereas Ttra3 was covered by a plastic tube to protect the mucosa. Core temperature was measured with a pulmonary artery catheter (Tpa). Pigs were cooled with a new surface cooling device (Emcoolspad®, Vienna, Austria). Data are presented as mean (±SD), and mean differences (95% CI). Results: Emcoolspad® decreased Tpa from 38.5°C to 33°C in 31±10 min, which translates into a cooling rate of 11.9±3.8°C/h. Overall mean differences of tracheal temperatures to pulmonary artery temperature (Tpa) are shown in table 1 . Ttra 1 showed the least difference to Tpa, followed by Ttra 2 and Ttra 3. There was a significant difference in temperature differences (Ttra-Tpa) related to temperature measurement site on the tracheal tube (p<0.007). Conclusions: The temperature probe proximal of the cuff (Ttra 1) reflects best pulmonary artery temperature. It seems to be an accurate surrogate for core temperature during the induction of mild hypothermia. The industry is asked to provide a tracheal tube with a temperature sensor for simple temperature monitoring during fast cooling to facilitate the implementation of mild hypothermia after cardiac arrest in the out-of-hospital setting.

scholarly journals A Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID-19 Severity

2020 ◽  
Vol 144 (12) ◽  
pp. 1457-1464 ◽  
Author(s):  
Elena Aloisio ◽  
Mariia Chibireva ◽  
Ludovica Serafini ◽  
Sara Pasqualetti ◽  
Felicia S. Falvella ◽  
...  
Keyword(s):  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Troponin T ◽  
Severe Disease ◽  
Negative Likelihood Ratio ◽  
Likelihood Ratios ◽  
Lactate Dehydrogenase Activity ◽  
Reactive Protein ◽  
Low Concentrations ◽  
High Concentrations

Context.— A relevant portion of coronavirus disease 2019 (COVID-19) patients develop severe disease with negative outcomes. Several biomarkers have been proposed to predict COVID-19 severity, but no definite interpretative criteria have been established to date for stratifying risk. Objective.— To evaluate 6 serum biomarkers (C-reactive protein, lactate dehydrogenase, D-dimer, albumin, ferritin, and cardiac troponin T) for predicting COVID-19 severity and to define related cutoffs able to aid clinicians in risk stratification of hospitalized patients. Design.— A retrospective study of 427 COVID-19 patients was performed. Patients were divided into groups based on their clinical outcome: nonsurvivors versus survivors and patients admitted to an intensive care unit versus others. Receiver operating characteristic curves and likelihood ratios were employed to define predictive cutoffs for evaluated markers. Results.— Marker concentrations at peak were significantly different between groups for both selected outcomes. At univariate logistic regression analysis, all parameters were significantly associated with higher odds of death and intensive care. At the multivariate analysis, high concentrations of lactate dehydrogenase and low concentrations of albumin in serum remained significantly associated with higher odds of death, whereas only low lactate dehydrogenase activities remained associated with lower odds of intensive care admission. The best cutoffs for death prediction were greater than 731 U/L for lactate dehydrogenase and 18 g/L or lower for albumin, whereas a lactate dehydrogenase activity lower than 425 U/L was associated with a negative likelihood ratio of 0.10 for intensive treatment. Conclusions.— Our study identifies which biochemistry tests represent major predictors of COVID-19 severity and defines the best cutoffs for their use.

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