Abstract
Objective
Reliable and accurate temperature assessment is fundamental for clinical monitoring;
noninvasive thermometers of various designs are widely used in intensive care units,
sometimes without a specific assessment of their suitability and interchangeability.
This study evaluated agreement of four noninvasive thermometers with a pulmonary artery
catheter temperature.
Methods
This prospective method comparison study was conducted in an Australian adult intensive
care unit. One hundred postoperative adult cardiothoracic surgery patients who had
a pulmonary artery catheter (Edwards Lifescience) in situ were identified. The temperature
reading from the pulmonary artery catheter was compared to contemporaneous measurements
returned by four different thermometers—temporal Artery (TA, Technimed), Per Axilla
(Axilla, Welch Allyn), Tympanic (Tymp, Covidien), and the NexTemp® (NEXT, Medical
Indicators [used per axilla]). The time required to obtain each noninvasive temperature
measurement was recorded.
Results
Agreements between each noninvasive temperature and the pulmonary artery catheter
standard were assessed using summary statistics and the Bland–Altman method comparison
approach. A clinically acceptable maximum difference from the standard was defined
as ±0.5 °C. Temperature agreement with the pulmonary artery standard (mean difference
°C [95% limits of agreement °C]) was greatest for Tymp (−0.20 [−0.92 to 0.52]), intermediate
for AXILLA (−0.37 [−1.3 to 0.59]) and NEXT (−0.71 [−1.7 to 0.27]), and least for TA
(−0.60 [−2.0 to 0.81]). The proportion of measurements within ±0.5 °C of the standard
were TYMP (81%), AXILLA (63%), TA (45%), and NEXT (30%). The time to obtain measurements
varied, with the Tymp and TA estimates immediate, the AXILLA a mean of 40 s (standard
deviation = 11 s), while NEXT results were at the manufacturer-recommended 3-min point.
Conclusions
Tympanic thermometers showed closest agreement with the pulmonary artery standard.
Deviations by more than 0.5 °C from that standard were relatively common with all
noninvasive devices.
Keywords
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References
- New sepsis definition changes incidence of sepsis in the intensive care unit.Crit Care Resusc. 2017; 19: 26
- A systematic review of the accuracy of peripheral thermometry in estimating core temperatures among febrile critically ill patients.Crit Care Resusc. 2011 Sep; 13: 194-199
- Association of triage hypothermia with in-hospital mortality among patients in the emergency department with suspected sepsis.J Crit Care. 2020 Dec 1; 60: 27-31
- Diagnosis and management of temperature abnormality in ICUs: a EUROBACT investigators' survey.Crit Care. 2013; 17: R289
- Accuracy of peripheral thermometers for estimating temperature: a systematic review and meta-analysis.Ann Intern Med. 2015 Nov 17; 163: 768-777
- Accuracy of non-invasive body temperature measurement methods in adult patients admitted to the intensive care unit: a systematic review and meta-analysis.Crit Care Resusc. 2021 Mar 1; 23: 6-13
- Accuracy of non-invasive body temperature measurement methods in critically ill patients: a prospective, bicentric, observational study.Crit Care Resusc. 2021 Sep 6; 23: 346-353
- Encyclopedia of survey research methods.([Internet]. 2455 Teller Road, 91320) Sage Publications, Inc., Thousand Oaks, California, USA2008 ([cited 2022 Mar 29]. Available from:)
- Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inf. 2009 Apr 1; 42: 377-381
Medical Indicators. NexTemp® “How to Use” Celsius Presentation [Internet]. Hamilton, NJ: Medical Indicators; [cited 2021 Jun 27]. Available from: https://www.medicalindicators.com/wp-content/uploads/2020/03/MII-NexTemp-How-to-Use-Slides-C.pdf.
- SureTemp® plus 692 electronic thermometer.([Internet]) Welch Allyn, Skaneateles Falls, NY2018 ([cited 2021 Jun 27]. Available from:)
- How to use.(Internet) Visofocus, Vedano Olona, Varese2013 ([cited 2021 Jun 27]. Available from)
- Operating manual Genius 2 tympanic thermometer and base.(Internet) Covidien, Mansfield, MA2011 ([cited 2021 Jun 27]. Available from:)
- The accuracy of temperature measurements provided by the Edwards lifesciences pulmonary artery catheter.Anesth Analg. 2016 May; 122: 1480-1483
Medical Indicators. NexTemp® general product literature [Internet]. Hamilton, NJ: Medical Indicators; [cited 2021 Jun 27]. Available from: https://www.medicalindicators.com/wp-content/uploads/2020/03/NexTemp-Thermometer-General-Literature.pdf.
- Specifications.(Internet) Visofocus, Vedano Olona, Varese2013 ([cited 2021 Jun 27]. Available from)
- Measuring agreement in method comparison studies.Stat Methods Med Res. 1999 Jun; 8: 135-160
- Passing-bablok & bland-altman methods: user-written command agree for Stata.(Internet) Universitat Autònoma de Barcelona, Barcelona: Bellaterra2019 (Available from:)
- Stata statistical software: release. vol. 17. StataCorp LLC, College Station, TX2021
- Accuracy and precision of noninvasive temperature measurement in adult intensive care patients.Am J Crit Care. 2007 Sep; 16: 485-496
- Do peripheral thermometers accurately correlate to core body temperature?.Ann Emerg Med. 2016 Nov; 68: 562-563
- Temperature measurement in the adult emergency department: oral, tympanic membrane and temporal artery temperatures versus rectal temperature.Emerg Med J. 2016 Dec 1; 33: 843
- Tympanic temperature measurements: are they reliable in the critically ill? A clinical study of measures of agreement.Crit Care Med. 2007 Jan; 35: 155-164
- An evaluation of a zero-heat-flux cutaneous thermometer in cardiac surgical patients.Anesth Analg. 2014 Sep; 119: 543-549
- Evaluation of the novel non-invasive zero-heat-flux TcoreTM thermometer in cardiac surgical patients.J Clin Monit Comput. 2019 Feb; 33: 165-172
- Measuring core body temperature using a non-invasive, disposable double-sensor during targeted temperature management in post-cardiac arrest patients.Front Med. 2021 May 5; 8666908
Article info
Publication history
Published online: September 18, 2022
Accepted:
August 12,
2022
Received in revised form:
August 7,
2022
Received:
August 22,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
