Department of Internal Medicine, Universitary Hospital of Mostoles, Madrid, Spain.
Int J Clin Pract. 2011 Dec;65(12):1283-8. doi: 10.1111/j.1742-1241.2011.02794.x.
To study if a 24-h continuous monitoring of temperature reveals information not accessible through conventional care. This included omitted fever peaks and circadian and complexity characteristics that may correlate with specific aetiologies.
Ours was a prospective, observational study. A total of 62 patients, admitted to a general internal medicine ward, in whom a temperature > 38 °C had been observed the day before inclusion underwent a 24-h long continuous monitoring of both central and peripheral temperatures. The time series were recorded in a file, while they otherwise followed conventional care. Time series were analysed for standard statistics, chronobiological analysis (amplitude, mesor, acrophase, intra-daily variability) and complexity analysis (Approximate Entropy of both central and peripheral temperature, cross-ApEn). A month after discharge, the clinical reports were reviewed and a definitive diagnosis of the febrile syndrome was established.
A total of 62 patients were initially included. In six cases, no time series could be obtained because of technical problems, leaving 56 patients accessible for analysis. In 10 cases, no definitive diagnosis was established. Continuous monitoring detected a mean of 0.7 (CI = 0.27-1.33) peaks of fever (central temperature > 38.0 °C) unobserved by conventional care per patient. A proportion of 16% (CI = 6-26) of patients considered afebrile by conventional care had at least one fever peak detected by continuous monitoring. Circadian rhythm persisted or was exacerbated in febrile patients. Circadian amplitude was increased in patients with tuberculosis. Complexity analysis did not differ among different diagnostic groups, although in subgroup analysis, viral infections had a higher complexity than other infectious diseases.
Temperature Holter monitoring reveals fever peaks that pass otherwise unobserved. Furthermore, chronobiological and complexity analysis of the temperature profile may provide quick and easy 'hidden information', not available to conventional care.
研究 24 小时连续体温监测是否能提供常规护理无法获得的信息。这包括遗漏的发热高峰以及昼夜节律和复杂性特征，这些特征可能与特定病因相关。
我们进行了一项前瞻性、观察性研究。共有 62 名患者，他们在前一天体温 > 38°C 时被收入普通内科病房，对他们进行了长达 24 小时的中心和外周温度连续监测。时间序列记录在一个文件中，同时他们遵循常规护理。对时间序列进行了标准统计、生物节律分析（振幅、中值、峰相、日内变异性）和复杂性分析（中心和外周温度的近似熵、交叉 ApEn）。在出院后一个月，回顾临床报告并确定发热综合征的明确诊断。
最初纳入了 62 名患者。在 6 例患者中，由于技术问题无法获得时间序列，因此对 56 例患者进行了分析。在 10 例患者中，未确定明确的诊断。连续监测发现，每位患者平均有 0.7（CI = 0.27-1.33）个常规护理未观察到的发热高峰（中心温度 > 38.0°C）。在常规护理认为体温正常的患者中，有 16%（CI = 6-26）的患者至少有一个发热高峰被连续监测检测到。发热患者的昼夜节律持续或加重。肺结核患者的昼夜节律振幅增加。复杂性分析在不同诊断组之间没有差异，尽管在亚组分析中，病毒感染的复杂性高于其他传染病。
体温 Holter 监测可发现常规护理无法观察到的发热高峰。此外，体温曲线的生物节律和复杂性分析可能提供常规护理无法获得的快速简便的“隐藏信息”。
