Abstract：
Reliable and accurate temperature assessment is fundamental for clinical monitoring; noninvasive thermometers of various designs are widely used in intensive care units, sometimes without a specific assessment of their suitability and interchangeability. This study evaluated agreement of four noninvasive thermometers with a pulmonary artery catheter temperature.
This prospective method comparison study was conducted in an Australian adult intensive care unit. One hundred postoperative adult cardiothoracic surgery patients who had a pulmonary artery catheter (Edwards Lifescience) in situ were identified. The temperature reading from the pulmonary artery catheter was compared to contemporaneous measurements returned by four different thermometers-temporal Artery (TA, Technimed), Per Axilla (Axilla, Welch Allyn), Tympanic (Tymp, Covidien), and the NexTemp® (NEXT, Medical Indicators [used per axilla]). The time required to obtain each noninvasive temperature measurement was recorded.
Agreements between each noninvasive temperature and the pulmonary artery catheter standard were assessed using summary statistics and the Bland-Altman method comparison approach. A clinically acceptable maximum difference from the standard was defined as ±0.5 °C. Temperature agreement with the pulmonary artery standard (mean difference °C [95% limits of agreement °C]) was greatest for Tymp (-0.20 [-0.92 to 0.52]), intermediate for AXILLA (-0.37 [-1.3 to 0.59]) and NEXT (-0.71 [-1.7 to 0.27]), and least for TA (-0.60 [-2.0 to 0.81]). The proportion of measurements within ±0.5 °C of the standard were TYMP (81%), AXILLA (63%), TA (45%), and NEXT (30%). The time to obtain measurements varied, with the Tymp and TA estimates immediate, the AXILLA a mean of 40 s (standard deviation = 11 s), while NEXT results were at the manufacturer-recommended 3-min point.
Tympanic thermometers showed closest agreement with the pulmonary artery standard. Deviations by more than 0.5 °C from that standard were relatively common with all noninvasive devices.
This prospective method comparison study was conducted in an Australian adult intensive care unit. One hundred postoperative adult cardiothoracic surgery patients who had a pulmonary artery catheter (Edwards Lifescience) in situ were identified. The temperature reading from the pulmonary artery catheter was compared to contemporaneous measurements returned by four different thermometers-temporal Artery (TA, Technimed), Per Axilla (Axilla, Welch Allyn), Tympanic (Tymp, Covidien), and the NexTemp® (NEXT, Medical Indicators [used per axilla]). The time required to obtain each noninvasive temperature measurement was recorded.
Agreements between each noninvasive temperature and the pulmonary artery catheter standard were assessed using summary statistics and the Bland-Altman method comparison approach. A clinically acceptable maximum difference from the standard was defined as ±0.5 °C. Temperature agreement with the pulmonary artery standard (mean difference °C [95% limits of agreement °C]) was greatest for Tymp (-0.20 [-0.92 to 0.52]), intermediate for AXILLA (-0.37 [-1.3 to 0.59]) and NEXT (-0.71 [-1.7 to 0.27]), and least for TA (-0.60 [-2.0 to 0.81]). The proportion of measurements within ±0.5 °C of the standard were TYMP (81%), AXILLA (63%), TA (45%), and NEXT (30%). The time to obtain measurements varied, with the Tymp and TA estimates immediate, the AXILLA a mean of 40 s (standard deviation = 11 s), while NEXT results were at the manufacturer-recommended 3-min point.
Tympanic thermometers showed closest agreement with the pulmonary artery standard. Deviations by more than 0.5 °C from that standard were relatively common with all noninvasive devices.
摘要：
目的：可靠而准确的温度评估是临床监测的基础；各种设计的无创温度计广泛用于重症监护病房，有时没有对它们的适用性和互换性进行具体评估。这项研究评估了四个无创温度计与肺动脉导管温度的一致性。
方法：这项前瞻性方法比较研究是在澳大利亚一家成人重症监护病房进行的。确定了100名原位使用肺动脉导管（EdwardsLifescience）的术后成人心胸手术患者。将肺动脉导管的温度读数与四个不同温度计-颞动脉（TA，Technimed),PerAxilla(Axilla,WelchAllyn),鼓室（鼓室，Covidien),和NexTemp®(NEXT,医疗指标[按腋窝使用])。记录获得每个非侵入式温度测量所需的时间。
结果：使用汇总统计和Bland-Altman方法比较方法评估了每种无创温度与肺动脉导管标准之间的协议。与标准品的临床上可接受的最大差异定义为±0.5°C。温度与肺动脉标准的一致性（平均差°C[一致性°C的95％极限]）对于Tymp最大（-0.20[-0.92至0.52]），AXILLA的中间体（-0.37[-1.3至0.59]）和NEXT（-0.71[-1.7至0.27]），和最小的TA（-0.60[-2.0到0.81]）。在标准品的±0.5°C范围内的测量比例为TYMP（81％），AXILLA（63%），TA（45%），和下一个（30%）。获得测量的时间各不相同，根据Tymp和TA的估计，AXILLA的平均值为40s(标准偏差=11s)，而下一个结果是制造商推荐的3分钟点。
结论：鼓室温度计显示与肺动脉标准最接近。与该标准的偏差超过0.5°C对于所有非侵入性装置是相对常见的。
方法：这项前瞻性方法比较研究是在澳大利亚一家成人重症监护病房进行的。确定了100名原位使用肺动脉导管（EdwardsLifescience）的术后成人心胸手术患者。将肺动脉导管的温度读数与四个不同温度计-颞动脉（TA，Technimed),PerAxilla(Axilla,WelchAllyn),鼓室（鼓室，Covidien),和NexTemp®(NEXT,医疗指标[按腋窝使用])。记录获得每个非侵入式温度测量所需的时间。
结果：使用汇总统计和Bland-Altman方法比较方法评估了每种无创温度与肺动脉导管标准之间的协议。与标准品的临床上可接受的最大差异定义为±0.5°C。温度与肺动脉标准的一致性（平均差°C[一致性°C的95％极限]）对于Tymp最大（-0.20[-0.92至0.52]），AXILLA的中间体（-0.37[-1.3至0.59]）和NEXT（-0.71[-1.7至0.27]），和最小的TA（-0.60[-2.0到0.81]）。在标准品的±0.5°C范围内的测量比例为TYMP（81％），AXILLA（63%），TA（45%），和下一个（30%）。获得测量的时间各不相同，根据Tymp和TA的估计，AXILLA的平均值为40s(标准偏差=11s)，而下一个结果是制造商推荐的3分钟点。
结论：鼓室温度计显示与肺动脉标准最接近。与该标准的偏差超过0.5°C对于所有非侵入性装置是相对常见的。
