Tympanic temperature measurements: Are they reliable in the critically ill? A clinical study of measures of agreement

Simple item page
dc.contributor.authorMoran, J.
dc.contributor.authorPeter, J.
dc.contributor.authorSolomon, P.
dc.contributor.authorGrealy, B.
dc.contributor.authorSmith, T.
dc.contributor.authorAshforth, W.
dc.contributor.authorWake, M.
dc.contributor.authorPeake, S.
dc.contributor.authorPeisach, A.
dc.date.issued2007
dc.description.abstractOBJECTIVE: Accurate measurement of temperature is vital in the intensive care setting. A prospective trial was performed to compare the accuracy of tympanic, urinary, and axillary temperatures with that of pulmonary artery (PA) core temperature measurements. DESIGN: A total of 110 patients were enrolled in a prospective observational cohort study. SETTING: Multidisciplinary intensive care unit of a university teaching hospital. PATIENTS: The cohort was (mean +/- sd) 65 +/- 16 yrs of age, Acute Physiology and Chronic Health Evaluation (APACHE) II score was 25 +/- 9, 58% of the patients were men, and 76% were mechanically ventilated. The accuracy of tympanic (averaged over both ears), axillary (averaged over both sides), and urinary temperatures was referenced (as mean difference, Delta degrees centigrade) to PA temperatures as standard in 6,703 recordings. Lin concordance correlation (pc) and Bland-Altman 95% limits of agreement (degrees centigrade) described the relationship between paired measurements. Regression analysis (linear mixed model) assessed covariate confounding with respect to temperature modes and reliability formulated as an intraclass correlation coefficient. MEASUREMENTS AND MAIN RESULTS: Concordance of PA temperatures with tympanic, urinary, and axillary was 0.77, 0.92, and 0.83, respectively. Compared with PA temperatures, Delta (limits of agreement) were 0.36 degrees C (-0.56 degrees C, 1.28 degrees C), -0.05 degrees C (-0.69 degrees C, 0.59 degrees C), and 0.30 degrees C (-0.42 degrees C, 1.01 degrees C) for tympanic, urinary, and axillary temperatures, respectively. Temperature measurement mode effect, estimated via regression analysis, was consistent with concordance and Delta (PA vs. urinary, p = .98). Patient age (p = .03), sedation score (p = .0001), and dialysis (p = .0001) had modest negative relations with temperature; quadratic relationships were identified with adrenaline and dobutamine. No interactions with particular temperature modes were identified (p > or = .12 for all comparisons) and no relationship was identified with either mean arterial pressure or APACHE II score (p > or = .64). The average temperature mode intraclass correlation coefficient for test-retest reliability was 0.72. CONCLUSION: Agreement of tympanic with pulmonary temperature was inferior to that of urinary temperature, which, on overall assessment, seemed more likely to reflect PA core temperature.
dc.description.statementofresponsibilityMoran JL, Peter JV, Solomon PJ, Grealy B, Smith T, Ashforth W, Wake M, Peake SL, Peisach AR.
dc.identifier.citationCritical Care Medicine, 2007; 35(1):155-164
dc.identifier.doi10.1097/01.CCM.0000250318.31453.CB
dc.identifier.issn0090-3493
dc.identifier.issn1530-0293
dc.identifier.orcidMoran, J. [0000-0003-2311-0440]
dc.identifier.orcidSolomon, P. [0000-0002-0667-6947]
dc.identifier.orcidPeake, S. [0000-0001-6682-7973]
dc.identifier.urihttp://hdl.handle.net/2440/42874
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.source.urihttps://doi.org/10.1097/01.ccm.0000250318.31453.cb
dc.subjectAxilla
dc.subjectArteries
dc.subjectTympanic Membrane
dc.subjectUrine
dc.subjectHumans
dc.subjectCritical Illness
dc.subjectThermography
dc.subjectCatheterization, Swan-Ganz
dc.subjectMonitoring, Physiologic
dc.subjectBody Temperature
dc.subjectCritical Care
dc.subjectAPACHE
dc.subjectAnalysis of Variance
dc.subjectLinear Models
dc.subjectSensitivity and Specificity
dc.subjectProspective Studies
dc.subjectBlood Pressure
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectHospitals, University
dc.subjectSouth Australia
dc.subjectFemale
dc.subjectMale
dc.subjectBias
dc.titleTympanic temperature measurements: Are they reliable in the critically ill? A clinical study of measures of agreement
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Mathematical Sciences publications