Naslov
Are Tympanic Thermometers Reliable in Hematopoietic Stem Cell Recipients?

Autori
Sedlar, Marina ; Marić, Marijana ; Desnica, Lana ; Vrhovac, Radovan ; Sabol, Ivan ; Rustan, Nurka

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
The 46th Annual Meeting of the European Society for Blood and Marrow Transplantation: Nurses Group Poster Session (NP001-NP043). Bone Marrow Transplant 55 / - : Springer, 2020, 728-729

Skup
46th Annual Meeting of the European Society for Blood and Marrow Transplantation

Mjesto i datum
Madrid, Španjolska, 29.08.2020. - 01.09.2020

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
graft vs host disease

Sažetak
Background: Temperature, as one of the vital signs is very important, especially in neutropenic patients and it can be measured in several ways ; axillary, tympanic (ear), oral, or rectal. Ear and oral measurements provide results much quicker than axillary measurements and are both less invasive than the most precise rectal measurements. Reliability of tympanic temperature measurements has been proven for clinical purposes and axillary thermometers are nowadays frequently replaced with ear thermometers in lots of departments. The data is less clear for oral temperature measurements. However, both ear and oral temperature measurements can differ slightly from axillary measurements. This marginal difference, maybe not so important in non-neutropenic immunocompetent patients might have a greater importance in transplanted, neutropenic patients since fever remains the main indicator of infection. In immunocompromised patients infection often warrants microbiological work-up and prompt initiation of empiric wide-spectrum antibiotic therapy. In order to evaluate temperature measurements performed by different methods and its possible consequences, axillary and tympanic temperatures were measured simultaneously in a cohort of transplant patients. Methods: Eight consecutive patients who have received an allogeneic stem cell transplant at the Bone Marrow Transplantation Unit in the Department of Hematology University Hospital Zagreb were included in this study. All patients were in peritransplant period, and neutropenic at some days during the investigated period. Axillar and tympanic temperatures were measured over 15 consecutive days at ten timepoints (at 6, 8, 10 AM, 12, 2, 4, 6, 8, 10 PM, and 12 AM) in order to determine whether there is a difference between the two measurements. Tympanic temperature was measured with Covidien Genius™2 thermometer and axillar temperature was measured with glass thermometer with metal liquid for 5 minutes on an underarm that was dry prior to measurement. For statistical analysis paired sample t-test, Pearson correlation, and inter rater agreement - kappa test were used. Results: As expected, tympanic measurements were slightly higher. On average, across 877 measurements the difference between these two was 0.049 °C (standard deviation 0.314 °C ; range -1.1 - 1.3 °C) and the difference was statistically significant (p<0.0001). The values were in good correlation (r=0.854, p< 0.0001), furthermore, both types of temperature measurements were mostly congruent for febrile status (>38 °C) identification (kappa=0.756). Conclusions: Fever is very important in hematopoietic stem cell recipients, especially if they are neutropenic.Tympanic temperature measurement is easier and much faster than axillary measurement, which is the reason why it is nowadays broadly used in many departments. Our results on a limited number of patients confirm the differences in axillary and tympanic temperatures, but also show a high degree of their correlation especially for febrile status identification. We conclude that tympanic thermometers are reliable and can probably be used instead of axillary thermometers. However, the clinical importance of fever in neutropenic patients and the widespread use of tympanic thermometers due to few discrepancies observed warrants further evaluation in a bigger patient population.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

POVEZANOST RADA