The accuracy of a new infrared ear thermometer in patients undergoing cardiac surgery

PurposeTo evaluate the equivalency of the prototype of a new infrared ear thermometer (IRT 4000) in comparison to the temperature measurements of a pulmonary artery catheter (PAC) and a continual contact probe on the tympanic membrane.MethodsAfter approval by the local Ethics Committee, 26 (six female and 20 male) patients undergoing elective cardiac surgery were included in a single center open trial. During surgery, temperature measurements were recorded with the IRT 4000 in the left ear, and with a tympanic contact probe in the right ear, as well as with a PAC as reference. Measurements with the infrared ear thermometers and continual PAC values were recorded every six minutes.ResultsThe average temperature measured with the IRT 4000 was 0.08°C above the temperature of the PAC (95% confidence interval from -0.44-0.61°C).ConclusionInfrared ear thermometers 4000 temperature readings accurately reflect body core temperature and correlate well with the invasive PAC. Infrared ear thermometers may present a clinically useful alternative to the pulmonary artery thermometry for the measurement of core temperature in the perioperative setting or in the intensive care unit.RésuméObjectifÉvaluer ľéquivalence entre le prototype ďun nouveau thermomètre auriculaire infrarouge (IRT 4000), les mesures de température ďun cathéter de ľartère pulmonaire (CAP) et une sonde en contact permanent avec la membrane tympanique.MéthodeAvec ľaccord du Comité ďéthique, nous avons recruté 26 patients (6 femmes et 20 hommes), devant subir une intervention cardiaque réglée, pour une étude ouverte monocentrique. Pendant ľopération, la température a été mesurée avec le IRT 4000 dans ľoreille gauche et avec la sonde en contact avec le tympan dans ľoreille droite de même qu’avec le CAP comme point de référence. Les mesures faites avec les thermomètres infrarouges et les valeurs continues du CAP ont été enregistrées toutes les six minutes.RésultatsLa température moyenne mesurée avec le IRT 4000 a été de 0,08 °C au-dessus de la température notée avec le CAP (intervalle de confiance de 95 % de -0,44-0,61 °C).ConclusionLes mesures des thermomètres infrarouges 4000 correspondent précisément à la température centrale du corps et sont en corrélation avec le CAP. Les thermomètres auriculaires infrarouges peuvent remplacer la thermométrie de ľartère pulmonaire pour mesurer la température centrale dans le contexte périopératoire ou à ľunité des soins intensifs.

[1]  R. A. Barnes,et al.  Temperature monitoring practices during regional anesthesia , 1999 .

[2]  R. Erickson,et al.  Accuracy of infrared ear thermometry and other temperature methods in adults. , 1994, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[3]  D. Sessler,et al.  Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty , 1996, The Lancet.

[4]  K. Stavem,et al.  Accuracy of infrared ear thermometry in adult patients , 1997, Intensive Care Medicine.

[5]  J. Youngblut,et al.  A comparison of pulmonary artery, rectal, and tympanic membrane temperature measurement in the ICU. , 1993, Heart & lung : the journal of critical care.

[6]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[7]  Joseph Foss,et al.  Comparing Methods of Clinical Measurement: Reporting Standards for Bland and Altman Analysis , 2000, Anesthesia and analgesia.

[8]  A. Giuliano,et al.  Temperature measurement in critically ill adults: a comparison of tympanic and oral methods. , 2000, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[9]  M. Ozaki,et al.  The accuracy and precision of four infrared aural canal thermometers during cardiac surgery , 1998, Acta anaesthesiologica Scandinavica.

[10]  S. Frank,et al.  The accuracy and precision of body temperature monitoring methods during regional and general anesthesia. , 2000 .

[11]  M. Ozaki,et al.  A comparison of four infrared tympanic thermometers with tympanic membrane temperatures measured by thermocouples , 1996, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[12]  R S Erickson,et al.  Comparison of ear‐based, bladder, oral, and axillary methods for core temperature measurement , 1993, Critical care medicine.

[13]  T. Terndrup,et al.  Comparison of infrared ear thermometer derived and equilibrated rectal temperatures in estimating pulmonary artery temperatures. , 1996, Critical care medicine.

[14]  Perioperative Maintenance of Normothermia Reduces the Incidence of Morbid Cardiac Events: A Randomized Clinical Trial , 1997 .

[15]  S. VanderBrug Medendorp,et al.  Tympanic Membrane Temperatures Compared to Rectal and Oral Temperatures , 1991 .

[16]  R. Yetman,et al.  Comparison of aural infrared with traditional rectal temperatures in children from birth to age three years. , 1994, The Journal of pediatrics.

[17]  K K Giuliano,et al.  Temperature measurement in critically ill orally intubated adults: a comparison of pulmonary artery core, tympanic, and oral methods. , 1999, Critical care medicine.

[18]  E. Martin,et al.  Effects of preinduction and intraoperative warming during major laparotomy. , 1998, British journal of anaesthesia.

[19]  A. Kurz,et al.  Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. , 1996, The New England journal of medicine.

[20]  W. Buhre,et al.  Perioperative management and monitoring in anaesthesia , 2003, The Lancet.

[21]  M. Petersen,et al.  Can training improve the results with infrared tympanic thermometers? , 1997, Acta anaesthesiologica Scandinavica.

[22]  M. Joffres,et al.  Oesophageal, rectal, axillary, tympanic and pulmonary artery temperatures during cardiac surgery , 1998, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[23]  Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. , 1996, The New England journal of medicine.

[24]  Paula R Williamson,et al.  Infrared ear thermometry compared with rectal thermometry in children: a systematic review , 2002, The Lancet.