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Infrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children
Marianne M Nimah1, Khaled Bshesh, Janice D Callahan
1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Infrared tympanic thermometry (ITT) provides accurate core body temperature readings in children, outperforming rectal, forehead, and axillary methods. This noninvasive technique is a reliable alternative for monitoring fever in pediatric patients.
Area of Science:
- Pediatric critical care
- Thermometry and temperature monitoring
Background:
- Accurate core body temperature measurement is crucial for managing febrile illnesses in children.
- Traditional methods like rectal, axillary, and forehead thermometry have limitations in accuracy and invasiveness.
Purpose of the Study:
- To compare the accuracy of infrared tympanic thermometry (ITT) against core body temperature (bladder) measurements.
- To evaluate ITT's performance relative to rectal, forehead, and axillary temperature readings during fever cycles in children.
Main Methods:
- A prospective cohort study was conducted in pediatric and cardiac intensive care units.
- Simultaneous temperature measurements were taken using ITT, indwelling bladder (core), axillary, forehead, and rectal methods in 36 critically ill children (<7 years) with bladder catheters.
- Data were collected during both febrile and nonfebrile periods.
Main Results:
- ITT measurements showed minimal deviation (0.03 ± 1.43°F) from core temperatures, demonstrating superior agreement compared to rectal (0.62 ± 1.44°F), forehead (0.56 ± 1.81°F), and axillary (1.25 ± 1.73°F) measurements.
- ITT exhibited better agreement during both increasing and decreasing temperature cycles.
- Receiver operating characteristic analysis confirmed ITT's superior performance (AUC 0.855) compared to rectal (0.777), forehead (0.710), and axillary (0.664) measurements.
Conclusions:
- Infrared tympanic thermometry (ITT) is a more accurate method for reflecting core body temperature in children than axillary, forehead, or rectal measurements.
- ITT offers a reproducible and relatively noninvasive alternative to bladder or rectal temperature monitoring in febrile children.
Objective:
: To determine whether infrared tympanic thermometry (ITT) measurements more accurately reflect core body temperatures than axillary, forehead, or rectal measurements during fever cycles in children.
Design:
: Prospective cohort study.
Setting:
: Pediatric and cardiac intensive care units at a tertiary care children's hospital.
Patients:
: Critically ill children <7 yrs of age with indwelling bladder catheters.
Interventions:
: Simultaneous temperatures were recorded during both febrile and nonfebrile periods using ITT, indwelling bladder (core), axillary, forehead, and indwelling rectal measurements in 36 children.
Measurements And Main Results:
: Overall ITT measurements were 0.03 +/- 1.43 degrees F less than core temperature measurements. In comparison, rectal, forehead, and axillary measurements averaged 0.62 +/- 1.44, 0.56 +/- 1.81, and 1.25 +/- 1.73 degrees F less than core temperature measurements. ITT measurements had better agreement with core measurements during increasing and decreasing temperature cycles. Receiver operating characteristic analysis performed on increasing and decreasing temperature cycle data revealed that ITT measurements performed well, with an area under the curve of 0.855 (95% confidence interval, 0.797-0.913) in comparison with rectal measurement area under the curve of 0.777 (95% confidence interval, 0.701-0.853), forehead measurement area under the curve of 0.710 (95% confidence interval, 0.715-0.888), and axillary measurement area under the curve of 0.664 (95% confidence interval, 0.579-0.750).
Conclusions:
: ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children. ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children.
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