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Comparison of Oral and Axillary Temperatures in Intubated Pediatric Patients
Danielle Wood1, Mary Heitschmidt1, Louis Fogg1
1Rush University Medical Center, Chicago, IL, United States.
Insights
Oral temperature measurement is a safe and effective alternative to axillary temperature readings in intubated pediatric patients. This study supports a practice change for improved pediatric critical care.
Area of Science:
- Pediatric critical care medicine
- Clinical thermometry
- Patient monitoring
Background:
- Accurate body temperature measurement is crucial for critically ill children.
- Current practice in Pediatric Intensive Care Units (PICUs) often uses axillary temperatures for intubated patients.
- Axillary temperatures exhibit greater variance compared to other measurement methods.
Purpose of the Study:
- To evaluate the viability of oral temperature measurement in endotracheally intubated pediatric patients.
- To compare oral and axillary temperature measurements in neonates, infants, and children.
- To determine if ventilator-induced temperature changes affect oral readings in pediatric patients.
Main Methods:
- Simultaneous oral and axillary temperatures were recorded in endotracheally intubated pediatric patients.
- Patients were categorized into neonate, infant, and children age groups.
- Descriptive statistics and Bland-Altman analysis were used to assess temperature correlations.
Main Results:
- A high positive correlation was observed between oral and axillary temperatures across all pediatric age groups.
- The infant group showed a slightly lower correlation and some instances of lower oral temperatures compared to axillary.
- Bland-Altman plots confirmed the reliability of oral temperature measurements.
Conclusions:
- Oral temperature measurement is a practical and reliable alternative to axillary measurements in intubated pediatric patients.
- Age-specific correction factors were developed to predict axillary temperatures from oral readings.
- Findings support a practice change towards utilizing oral temperature measurement in this patient population.
Purpose:
Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures. This study sought to determine if the same is true in pediatrics.
Design And Methods:
Oral and axillary temperatures of endotracheally intubated pediatric patients were obtained during unit prescribed vital assessment intervals. Patients were divided into neonate, infant, and children age groups with 25 sets of temperatures obtained for each group. Descriptive statistics and Bland-Altman plot interpretation were performed to determine confidence intervals for each age group.
Results:
Bland-Altman plot analysis of oral and axillary routes of temperature measurement showed a high positive correlation within all age groups studied. The infant age group showed lower correlation in comparison to neonates and children. The infant age group also had an outlier of data sets with lower oral temperatures as compared to the axilla.
Conclusions:
Oral temperature measurement is a viable alternative to axillary temperature measurement in endotracheally intubated pediatric patients. Correction factors for age groups were calculated for prediction of axillary temperature based on measured oral temperature.
Practical Implications:
This study serves as evidence for practice change within the studied unit.
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