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Published on: November 21, 2017
Can there be a standard for temperature measurement in the pediatric intensive care unit?
Sarah A Martin1, Andrea M Kline
1Dept of Pediatric Surgery, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA. smartin@childrensmemorial.org
Insights
Accurate temperature measurement in critically ill children is vital but challenging due to undefined parameters and diverse routes. This review summarizes research to improve clinical decision-making for pediatric thermal instability.
Area of Science:
- Pediatric critical care medicine
- Clinical thermoregulation research
- Biomedical instrumentation
Background:
- Temperature measurement is crucial for critically ill children.
- Defining clinically significant thermal instability and interpreting measurement modes remain poorly understood.
- Physioanatomic differences in infants and children affect thermoregulation.
Purpose of the Study:
- To summarize existing research on temperature measurement in critically ill children.
- To provide clarity on interpreting temperature readings and managing thermal instability.
- To inform clinical decision-making for pediatric patient care.
Main Methods:
- Review of numerous studies on temperature measurement in children of various ages.
- Inclusion of data from neonatal intensive care unit, pediatric intensive care unit, operating room, and inpatient settings.
- Summary of research on diverse temperature measurement routes (oral, rectal, tympanic, etc.) and thermometer types.
Main Results:
- Multiple routes exist for temperature measurement, each with specific considerations.
- Limited studies specifically target critically ill children, necessitating data synthesis from related pediatric populations.
- Variability in study designs and populations complicates direct comparisons.
Conclusions:
- Standardized guidelines for temperature measurement interpretation in critically ill children are needed.
- Further research focusing on the unique challenges of pediatric critical care is essential.
- Improved understanding of thermoregulation can enhance patient management and outcomes.
Abstract:
Temperature measurement is a commonly used assessment parameter when caring for the critically ill child. Interpreting the temperature measurement mode and what constitutes clinically significant thermal instability are poorly defined. Thus, decisions made regarding patient management based on temperature measurement can be challenging for caregivers. Infants and children have unique physioanatomic considerations that impact maintaining thermoregulation. Numerous routes for taking temperature measurements are described including the oral, axillary, tympanic (aural), rectal, skin, urinary bladder, pulmonary artery, esophageal, nasopharyngeal, supralingual (pacifier), and temporal-artery. Numerous studies on temperature measurement have been conducted on children of various ages using a variety of thermometers and routes in both the inpatient and outpatient setting. Although there are limited studies reported on the critically ill child, research data pertinent to the critically ill child from subjects in the neonatal intensive care unit, pediatric intensive care unit, operating room, and inpatient units are summarized.
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