OBJECTIVE: To determine the accuracy of axillary temperature relative to core rectal temperature during whole-body therapeutic hypothermia for moderate-to-severe hypoxic-ischaemic encephalopathy. DESIGN: Retrospective audit. SETTING:Single tertiary neonatal intensive care unit at The Royal Women's Hospital in Australia. PATIENTS: Fifty-eight term newborn infants with moderate-to-severe hypoxic-ischaemic encephalopathy. Forty infants were treated with whole-body hypothermia between February 2001 and May 2010, 16 of whom were enrolled in the Infant Cooling Evaluation (ICE) trial, and 18 control infants randomised to normothermia in the ICE trial. INTERVENTION: Comparison of simultaneous axillary and rectal temperatures measured between 0 and 84 h post randomisation or induction of cooling. RESULTS: During the initiation of hypothermia (0-<6 h) axillary and rectal temperatures were similar (mean difference rectal-axillary =0.07°C), but with large variability (95% limits of agreement -1.18 to 1.33°C). There was larger variability in measurements between 6 and <72 h in the hypothermic infants (total SD 0.44) than in the normothermic group (total SD 0.24, p<0.001). In the hypothermic infants, the mean difference between the measurements during the rewarming phase (72-<84 h) was -0.19°C (95% limits of agreement -0.95 to 0.57°C). CONCLUSION: As there is wide variability in the difference between axillary and rectal temperatures at all stages of whole-body cooling, our data do not support the use of axillary temperature as a surrogate for core rectal temperature during therapeutic hypothermia.
RCT Entities:
OBJECTIVE: To determine the accuracy of axillary temperature relative to core rectal temperature during whole-body therapeutic hypothermia for moderate-to-severe hypoxic-ischaemic encephalopathy. DESIGN: Retrospective audit. SETTING: Single tertiary neonatal intensive care unit at The Royal Women's Hospital in Australia. PATIENTS: Fifty-eight term newborn infants with moderate-to-severe hypoxic-ischaemic encephalopathy. Forty infants were treated with whole-body hypothermia between February 2001 and May 2010, 16 of whom were enrolled in the Infant Cooling Evaluation (ICE) trial, and 18 control infants randomised to normothermia in the ICE trial. INTERVENTION: Comparison of simultaneous axillary and rectal temperatures measured between 0 and 84 h post randomisation or induction of cooling. RESULTS: During the initiation of hypothermia (0-<6 h) axillary and rectal temperatures were similar (mean difference rectal-axillary =0.07°C), but with large variability (95% limits of agreement -1.18 to 1.33°C). There was larger variability in measurements between 6 and <72 h in the hypothermic infants (total SD 0.44) than in the normothermic group (total SD 0.24, p<0.001). In the hypothermic infants, the mean difference between the measurements during the rewarming phase (72-<84 h) was -0.19°C (95% limits of agreement -0.95 to 0.57°C). CONCLUSION: As there is wide variability in the difference between axillary and rectal temperatures at all stages of whole-body cooling, our data do not support the use of axillary temperature as a surrogate for core rectal temperature during therapeutic hypothermia.
Authors: An N Massaro; Heather E Campbell; Marina Metzler; Tareq Al-Shargabi; Yunfei Wang; Adre du Plessis; Rathinaswamy B Govindan Journal: Pediatr Crit Care Med Date: 2017-04 Impact factor: 3.624
Authors: Stephanie Redpath; Heather Moore; Ewa Sucha; Amisha Agarwal; Nicholas Barrowman; Brigitte Lemyre; Louise St Germain Journal: Pediatr Qual Saf Date: 2022-06-14
Authors: John J Kim; Nathan Buchbinder; Simon Ammanuel; Robert Kim; Erika Moore; Neil O'Donnell; Jennifer K Lee; Ewa Kulikowicz; Soumyadipta Acharya; Robert H Allen; Ryan W Lee; Michael V Johnston Journal: Med Devices (Auckl) Date: 2013-01-03