Ali BÜLBÜL, Emrah CAN, Asiye NUHOĞLU, Sinan USLU

Yenidoğan yoğun bakım birimindeki hastalarda temassız infrared alın termometresi ile standart termometrelerin karşılaştırılması

Amaç: Bu çalışmada yenidoğan döneminde temassız infrared alın termometresi ile civalı termometre ve dijital termometre ölçümlerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Çalışmaya rastgele seçilmiş 179 yenidoğan alındı. Isı ölçümleri infrared derece ile alından, diğer iki termometre ile de koltuk altından olmak üzere eş zamanlı olarak üç farklı teknik ile yapıldı. Ölçümlerde Thermoflash LX-26 (France-China) marka temassız infrared alın termometresi, MC-203-E (Omron Health Care, Europe) dijital termometre ve civalı cam geleneksel termometre kullanıldı. Her ölçüm cihazı ile 2091 defa ölçüm olmak üzere toplam 6273 ölçüm yapıldı. Bulgular: Elde edilen ortalama değerler ve standart sapmalar sırasıyla temassız infrared alın termometresi için 37,2±0,5 °C, civalı termometre için 36,7±0,4 °C, ve dijital termometre için 36,6±0,4 °C olarak saptandı. Bland Altman eğrisine göre temassız infrared alın termometresi ile yapılan ölçümlerin %95 güven aralığında, kabul edilen sınırlarda civalı termometre sonuçlarına göre -0.37°C ve +1.54°C aralığı arasında, dijital termometre sonuçlarına göre -0,40°C ve +1,54°C aralığında olduğu saptandı. Temassız infrared alın termometresinin duyarlılığı yüksek (%81), özgünlüğü düşük (%50) olarak belirlendi [%95 güven aralığı (41,6-58,4)]. Çıkarımlar: Temassız infrared alın termometresinin yenidoğan yoğun bakım birimlerinde yatan bebeklerde vücut ısısının değerlendirilmesi amacıyla kullanılamayacağı sonucuna varıldı.

Comparison of non-contact infrared forehead thermometer to standard temperature measurement in neonatal intensive care unit patients

Aim: In this study, we aimed to compare non-contact infrared forehead thermometer measurement with the mercury thermometer and digital thermometer measurements in the neonatal period. Material and Method: A total of 179 newborns who were admitted to our hospital were enrolled, and simultaneous temperature measurements were performed via three devices. Mesaurements were made from forehead with non-contact infrared thermometer and from axillar region with digital thermometers and conventional thermometers. Thermoflash LX-26 (France-China) thermometer was used for non-contact infrared mesasurement, MC-203-E (Omron Health Care, Europe) thermometer for digital measurement and glass mercury thermometer for conventional axillary measurement. A total of 6273 measurements were performed, being 2091 measurement for each method. Results: The mean results of the non-contact infrared forehead thermometer, mercury thermometers and digital thermometer were found as 37.2±0.5 °C, 36.7±0.4 °C, and 36.6±0.4 °C respectively. The Bland-Altman plots differences suggest that 95% of the non-contact infrared forhead thermometer readings were within the limits of agreement, which is -0.37 and +1.54 °C range of mercury thermometer and -0.40 and +1.54 °C range of digital thermometer respectively. The sensitivity and specificity of the non-contact infrared thermometer were found as 81% and 50% respectively [95% CI (41.6-58.4)]. Conclusions: We conclude that the non-contact infrared thermometer can not be recommended for assessment of body temperature in newborns admitted to neonatal intensive care unit.

PDF

___

1. Asher C, Northington L. Position statement for measurement of temperature/fever in children. J Pediatr Nurs 2008; 23: 234-6.
2. Blumenthal I. Should we ban the mercury thermometer? Discussion paper. J R Soc Med 1992; 85: 553-5.
3. Rosenthal H M, Leslie A. Measuring temperature of NICU patients-A comparison of three devices. J Neonatal Nurs 2006; 12: 125-9.
4. Ng DK, Chan CH, Lee RS, Leung LC. Non-contact infrared thermometry temperature measurement for screening fever in children. Ann Trop Paediatr 2005; 25: 267-75.
5. Kambarami R, Chidede O, Pereira N. ThermoSpot in the detection of neonatal hypothermia. Ann Trop Paediatr 2002; 22: 219-23.
6. Sehgal A, Dubey NK, Jyothi MC, Jain S. Comparison of tympanic and rectal temperature in febrile patients. Indian J Pediatr 2002; 69: 305-8.
7. Hebbar K, Fortenberry J D, Rogers K, Merritt R, Easley K. Comparison of temporal artery thermometer to standard temperature measurements in pediatric intensive care unit patients. Pediatr Crit Care Med 2005; 5: 557-61.
8. Klaus MH, Fanaroff AA. The physical environment. In: Klaus MH, Fanaroff AA (eds). Care of the high risk neonate. 5th ed. Edinburgh: Sauders, 2001: 130-46.
9. Devrim I, Kara A, Ceyhan M, et al. Measurement accuracy of fever by tympanic and axillary thermometry. Pediatr Emerg Care 2007; 23: 16-9.
10. Nimah MM, Bshesh K, Callahan JD, Jacobs BR. Infrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children. Pediatr Crit Care Med 2006; 7: 48-55.
11. Fallis WM. Monitoring urinary bladder temperature in the intensive care unit: state of the science. Am J Crit Care 2002; 11: 38-45.
12. Lefrant JY, Muller L, de La Coussaye JE, et al. Temperature measurement in intensive care patients: comparison of urinary bladder, oesophageal, rectal, axillary, and inguinal methods versus pulmonary artery core method. Intensive Care Med 2003; 29: 414-8.
13. Cultu O, Yildirim I, Ceyhan M, et al. Comparing body temperature measurements by mothers and physicians using mercury-in-glass, digital mercury and infrared tympanic membrane thermometers in healthy newborn babies. Turk J Pediatr 2008; 50: 354-8.
14. El-Radhi AS, Patel S. An evaluation of tympanic thermometry in a paediatric emergency department. Emerg Med J 2006; 23: 40-1.
15. Osinusi K, Njinyam MN. Comparison of body temperatures taken at different sites and the reliability of axillary temperature in screening for fever. Afr J Med Med Sci 1997; 26: 163-6.
16. Moya Villaescusa MJ, Sánchez Pérez A, Bermejo Fenoll A. Reliability of an infrared auditory thermometer in the measurement of oral temperature. Med Oral Patol Oral Cir Bucal 2008; 13: E385-9.
17. Mayfield SR, Bhatia J, Nakamura KT, Rios GR, Bell EF. Temperature measurement in term and preterm neonates. J Pediatr 1984; 104: 271-5.
18. Maloney SK, Fuller A, Mitchell G, Mitchell D. Rectal temperature measurement results in artifactual evidence of selective brain cooling. Am J Physiol Regul Integr Comp Physiol 2001; 281: R108-14.
19. van Staaij BK, Rovers MM, Schilder AG, Hoes AW. Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children. Int J Pediatr Otorhinolaryngol 2003; 67: 1091-7.
20. Liu CC, Chang RE, Chang WC. Limitations of forehead infrared body temperature detection for fever screening for severe acute respiratory syndrome. Infect Control Hosp Epidemiol 2004; 25: 1109-11.