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Title: Accuracy of non-invasive body temperature measurement methods in adult patients admitted to the intensive care unit: a systematic review and meta-analysis.
Austin Authors: Cutuli, Salvatore L ;See, Emily J ;Osawa, Eduardo A;Ancona, Paolo;Marshall, David;Eastwood, Glenn M ;Glassford, Neil J;Bellomo, Rinaldo 
Affiliation: Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome; Istituto di Anestesia e Rianimazione; Universit√† Cattolica del Sacro Cuore, Rome, Italy.
School of Medicine, University of Melbourne, Melbourne, VIC, Australia.
Intensive Care
Centre for Integrated Critical Care, School of Medicine, University of Melbourne, Melbourne, VIC, Australia.
Issue Date: Mar-2021
Date: 2023
Publication information: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2021-03; 23(1)
Abstract: Objective: Non-invasive thermometers are widely used in both clinical practice and trials to estimate core temperature. We aimed to investigate their accuracy and precision in patients admitted to the intensive care unit (ICU). Study design: Systematic review and meta-analysis. Data sources: We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to identify all relevant studies from 1966 to 2017. We selected published trials that reported the accuracy and precision of non-invasive peripheral thermometers (index test) in ICU patients compared with intravascular temperature measurement (reference test). The extracted data included the study design and setting, authors, study population, devices, and body temperature measurements. Methods: Two reviewers performed the initial search, selected studies, and extracted data. Study quality was assessed using the QUADAS-2 tool. Pooled estimates of the mean bias between index and reference tests and the standard deviation of mean bias were synthesised using DerSimonian and Laird random effects meta-analyses. Results: We included 13 cohort studies (632 patients, 105 375 measurements). Axillary, tympanic infrared and zero heat flux thermometers all underestimated intravascular temperature. Only oesophageal measurements showed clinically acceptable accuracy. We found an insufficient number of studies to assess precision for any technique. Study heterogeneity was high (99-100%). Risk of bias for the index test was unclear, mostly because of no device calibration or control for confounders. Conclusions: Compared with the gold standard of intravascular temperature measurement, non-invasive peripheral thermometers have low accuracy. This makes their clinical and trial-related use in ICU patients unreliable and potentially misleading.
DOI: 10.51893/2021.1.SR1
Journal: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Start page: 6
End page: 13
PubMed URL: 38046384
Type: Journal Article
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