Rotello L C, Crawford L, Terndrup T E
Department of Medicine, State University New York Health Science Center at Syracuse, USA.
Crit Care Med. 1996 Sep;24(9):1501-6. doi: 10.1097/00003246-199609000-00012.
To investigate the clinical accuracy of infrared ear thermometer derived and equilibrated rectal temperatures in estimating core body temperature. The clinical bias (i.e., mean difference between body sites), and variability (SD of the differences) of simultaneous temperatures were compared with pulmonary artery temperatures. Clinical repeatability (pooled SD of triplicate reading differences) was also examined for three ear infrared thermometers.
Prospective clinical study.
A multidisciplinary, adult intensive care unit.
Twenty patients with an existing pulmonary artery catheter were studied in a multidisciplinary, adult intensive care unit.
A single operator using optimum ear infrared technique and masked to ear and rectal temperatures recorded triplicate measurements with each of three infrared ear thermometers, each over a 4-min period with each infrared thermometer, while an assistant recorded temperatures. Infrared and rectal temperatures were compared with a simultaneous pulmonary artery temperature.
Infrared ear thermometers and rectal thermometers were calibrated daily, and pulmonary artery catheters were calibrated on removal from the patient. Patients were grouped into afebrile and febrile groups, based on initial pulmonary artery temperature. Bias and variability were compared between thermometers using analysis of variance. Clinical bias, but not variability, was significantly different between three ear infrared thermometers (0.16 +/- 0.46 degrees C, 0.07 +/- 0.38 degrees C, and -0.22 +/- 0.47 degrees C). The repeatability was not different between ear infrared thermometers (range 0.13 degrees C to 0.14 degrees C). Rectal temperature had a significantly greater bias (average 0.3 degrees C), but less variability (average 0.2 degrees C). Bias was increased, and variability decreased for both rectal and infrared ear temperatures when pulmonary artery temperature was increased.
The three infrared ear thermometers studied provided a closer estimate of core body temperature than equilibrated rectal temperature. Clinical bias was greatest in febrile vs. afebrile intensive care unit patients.
研究红外耳温计得出的温度以及平衡后的直肠温度在估计核心体温方面的临床准确性。将同时测量的体温的临床偏差（即不同身体部位之间的平均差异）和变异性（差异的标准差）与肺动脉温度进行比较。还对三款耳用红外体温计的临床可重复性（三次读数差异的合并标准差）进行了检测。
前瞻性临床研究。
一个多学科的成人重症监护病房。
在一个多学科的成人重症监护病房对20名已置入肺动脉导管的患者进行了研究。
由一名操作人员采用最佳耳用红外技术，在对耳温和直肠温度不知情的情况下，使用三款耳用红外体温计中的每一款，在4分钟内对每位患者进行三次测量，同时由一名助手记录温度。将红外体温和直肠体温与同时测量的肺动脉温度进行比较。
耳用红外体温计和直肠体温计每天校准，肺动脉导管在从患者身上取出时校准。根据初始肺动脉温度将患者分为无发热组和发热组。使用方差分析比较不同体温计之间的偏差和变异性。三款耳用红外体温计之间的临床偏差存在显著差异（分别为0.16±0.46℃、0.07±0.38℃和 -0.22±0.47℃），但变异性无显著差异。耳用红外体温计之间的可重复性无差异（范围为0.13℃至0.14℃）。直肠温度的偏差显著更大（平均0.3℃），但变异性更小（平均0.2℃）。当肺动脉温度升高时，直肠温度和耳用红外温度的偏差均增大，变异性均减小。
所研究的三款耳用红外体温计比平衡后的直肠温度能更准确地估计核心体温。在发热的重症监护病房患者与无发热的重症监护病房患者中，临床偏差最大。
