18 Nov Peripheral Thermometers May Not Be Accurate Especially In Critically Ill Patients
MedicalResearch.com Interview with:
Daniel Niven MD, MSc, FRCPC
Department of Critical Care Medicine
Department of Community Health Sciences
O’Brien Institute for Public Health
Cumming School of Medicine, University of Calgary
Medical Research: What is the background for this study?
Dr. Niven: Fever (temperature 38.0 degrees Celsius or higher) and hypothermia (temperature less than 36.0 degrees Celsius) are commonly included in diagnostic criteria for certain disorders, influence clinical decision making, and are associated with an increased risk for death in select patient populations. Therefore, accurately measuring body temperature is important. Unfortunately, the accuracy of many commonly employed thermometers is not well defined.
Medical Research: What are the main findings?
Dr. Niven: This systematic review and meta-analysis examined the accuracy of thermometers measuring temperature from peripheral sites (for example, forehead measurement devices) relative to central sites (for example, the bladder) in adults and children. From 75 studies and 8,682 patients, this meta-analysis found that the majority of commonly used peripheral thermometers do not have clinically acceptable accuracy among adults and children. This was especially the case for patients with fever and hypothermia, where peripheral temperature measurements may be as much as 1 to 2 degrees higher or lower than actual body temperature. Sensitivity for detection of fever was low (64%), whereas specificity was high (96%).
Medical Research: What should clinicians and patients take away from your report?
Dr. Niven: Peripheral thermometers do not accurately estimate body temperature, and should not be used when accurate measurement of body temperature will influence clinical decisions. Based on the incidence of temperature abnormalities, and their effect on patient outcomes, use of peripheral thermometers should be avoided in post-operative patients, those who are injured, those who are critically ill, and those with acute neurological illnesses. Instead, central thermometers should be used in these high-risk populations whenever practical and feasible.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Niven: Future research pertaining to body temperature measurement devices should focus on two areas.
First, there is the need for new technology to advance the ways in which body temperature is measured from peripheral sites.
Second, any new peripheral thermometer should be evaluated in high-quality diagnostic accuracy studies that include an adequate number of patients with fever and hypothermia.
Citation:
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Daniel Niven MD, MSc, FRCPC (2015). Peripheral Thermometers May Not Be Accurate Especially In Critically Ill Patients
Last Updated on November 18, 2015 by Marie Benz MD FAAD