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Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System
Hildy M Schell-Chaple1, Kathleen D Liu2, Michael A Matthay2
1Hildy M. Schell-Chaple is a clinical nurse specialist and an associate professor of nursing, University of California, San Francisco Medical Center, San Francisco, California. Kathleen D. Liu is a professor of medicine and Michael A. Matthay is a professor of medicine and anesthesia, University of California, San Francisco School of Medicine, San Francisco, California. Kathleen A. Puntillo is professor emeritus, University of California, San Fran-cisco School of Nursing, San Francisco, California. Hildegarde.schell-chaple@ucsf.edu.
Background:
Methods and frequency of temperature monitoring in intensive care unit patients vary widely. The recently available SpotOn system uses zero-heat-flux technology and offers a noninvasive method for continuous monitoring of core temperature of critical care patients at risk for alterations in body temperature.
Objective:
To evaluate agreement between and precision of a zero-heat-flux thermometry system (SpotOn) and continuous rectal and urinary bladder thermometry during fever and defervescence in adult patients in intensive care units.
Methods:
Prospective comparison of SpotOn vs rectal and urinary bladder thermometry in eligible patients enrolled in a randomized clinical trial on the effect of acetaminophen on core body temperature and hemodynamic status.
Results:
A total of 748 paired temperature measurements from 38 patients who had both SpotOn monitoring and either continuous rectal or continuous bladder thermometry were analyzed. Temperatures during the study were from 36.6°C to 39.9°C. The mean difference for SpotOn compared with bladder thermometry was -0.07°C (SD, 0.24°C; 95% limits of agreement, ± 0.47°C [-0.54°C, 0.40°C]). The mean difference for SpotOn compared with rectal thermometry was -0.24°C (SD, 0.29°C; 95% limits of agreement, ± 0.57°C [-0.81°C, 0.33°C]). Most differences in temperature between methods were within ± 0.5°C in both groups (96% bladder and 85% rectal).
Conclusions:
The SpotOn thermometry system has excellent agreement and good precision and is a potential alternative for noninvasive continuous monitoring of core temperature in critical care patients, especially when alternative methods are contraindicated or not available.
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