In a pediatric intensive care unit (PICU) in a Midwestern medical center, it was questioned whether oral temperatures are accurate in intubated patients due to heated gases passing through the endotracheal tube. Practice within the studied unit was to obtain axillary temperatures, but research shows this method has greater variability than other forms of measurement. Staff within the unit sought more concrete evidence whether oral temperatures were a reliable form of temperature measurement within the PICU.
Background:
Literature within adult intensive care unit populations showed that oral temperatures in intubated patients was not significantly affected by heated gases passing from the ventilator through the airway This study aimed to determine if the same was true in pediatric patients.
Methods:
Patient age groups were delineated into neonate (<28 days), infant (28 days to 12 months), and children (1 to 18 years). These age ranges were selected based on patient volumes cared for within the studied unit. Oral and axillary temperatures were obtained during normal vital assessment intervals within the unit. A group of nursing staff were recruited and trained for accurate temperature measurement within the study parameters. 25 sets of data were collected for each age group. Descriptive statistics and Bland-Altman plot interpretation were used to evalute confidence intervals for each age group.
Results:
High positive correlation was seen via Bland-Altman interpretation for all age groups. Infants showed slightly lower positive correlation in comparison to the other age groups. Correction factors were calculated for each age group, which allow prediction of an axillary temperature based upon the measured oral temperature.
Conclusion:
Oral temperature measurement is an acceptable temperature measurement for intubated pediatric patients. This study serves as a pilot due to the small number of patients included within the study. More robust data should be sought by studying more patients as well as constructing data collection that includes patient environmental, diagnostic, and equipment factors.