Axillary and rectal thermometry in the newborn: do they agree?

Charafeddine, Lama; Tamim, Hani; Hassouna, Habiba; Akel, Reem; Nabulsi, Mona

doi:10.1186/1756-0500-7-584

Cited by 25 publications

(20 citation statements)

References 10 publications

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“…Similar results have been presented in later research, in which axillary temperatures were significantly lower than rectal temperatures for young children, infants and neonates (17)(18)(19). On the other hand, Charafeddine et al (10) found no significant difference between axillary and rectal temperature measurements in a sample of 118 infants.…”

Section: Introductionsupporting

confidence: 85%

“…A Wilcoxon matched-pairs signed-rank test showed this difference to be significant (z = 11.1, p < 0.001). When the study population consists of neonates, age should be viewed in terms of gestational age as well as chronological age (10) The difference between axillary and rectal temperatures has been found to be lower during night-time (19) The body temperature of the patient has been found to correlate positively with the size of the difference between axillary and rectal temperatures (17,19) Incubator care has been found to create a stronger correlation between skin and rectal temperatures (20) Kangaroo care might be associated with larger temperature differences (20) The difference between axillary and rectal temperatures has been found to be larger for babies with Caesarean delivery (10) The sexr of the patient might also have explanatory value. The 95% confidence interval of the temperature difference was 0.356 AE 0.032.…”

Section: Resultsmentioning

confidence: 99%

“…In a review of 40 studies, Craig et al (16) found that the pooled mean temperature differencerectal minus axillary temperaturewas 0.17°C for newborns and 0.92°C for older children and young people. On the other hand, Charafeddine et al (10) found no significant difference between axillary and rectal temperature measurements in a sample of 118 infants. Similar results have been presented in later research, in which axillary temperatures were significantly lower than rectal temperatures for young children, infants and neonates (17)(18)(19).…”

Section: Introductionmentioning

confidence: 89%

“…Several recent studies have reported on the accuracy of noninvasive temperature measurement methods for children (3)(4)(5)(6)(7)(8), and the overall picture is that such methods can, at best, serve as an alternative with limited reliability to rectal temperature measurement. Even though rectal temperature, which determines the core temperature with high precision, is widely viewed as the gold standard for body temperature measurement (9), axillary temperature measurement is frequently used in practice as it is considered safe and convenient (10)(11)(12). Potential complications of rectal measurement, such as the spread of infection (13) and rectal perforation (14), are other reasons for using axillary measurements.…”

Section: Introductionmentioning

confidence: 99%

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Using axillary temperature to approximate rectal temperature in newborns

Lantz

Ottosson

2015

Acta Paediatrica

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Although it is possible to construct a formula that estimates neonate rectal temperature based on axillary temperature with a slightly higher reliability than simply adding a fixed value like 0.4°C, such a formula would be too complex to apply in practice. Adding 0.3°C or 0.4°C to the measured axillary temperature for premature infants or full-term infants, respectively, yields acceptable approximations in most cases.

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Section: Introductionsupporting

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Using axillary temperature to approximate rectal temperature in newborns

Lantz

Ottosson

2015

Acta Paediatrica

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“…There are conflicting results regarding the accuracy and precision of axillary temperature [13,14,15]. However, it has been reported that in 108 term and preterm infants (29-41 weeks of gestation) who were clinically stable, the mean axillary (36.8 ± 0.4°C) and rectal (36.8 ± 0.5°C) temperatures were similar [16]. Although our study was randomised, the proportion of SGA infants was slightly higher in the axilla group, which may have rendered that group more susceptible to hypothermia.…”

Section: Discussionmentioning

confidence: 99%

Temperature Probe Placement during Preterm Infant Resuscitation: A Randomised Trial

et al. 2017

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Background: Hypothermia on admission to intensive care is associated with poor outcomes in preterm infants. The neonatal resuscitation program recommends the use of servo-control thermoregulation during resuscitation. Very little evidence exists to guide optimal temperature probe placement in the delivery room. Objective: The aim of this work was to determine, in moderately preterm infants, if temperature probe placement in the dorsal, thoracic, or axillary area during delivery room resuscitation would result in differing temperatures on admission to the neonatal intensive care unit (NICU). Methods: A randomised trial with 3 arms was conducted. In total, 122 inborn preterm infants born between 28^0/7 and 35^6/7 weeks of gestational age were recruited. The infants were randomly assigned to thermal probe placement in the left lower back, left upper thorax, or left axilla immediately after birth. Temperature was servo-controlled using an infant resuscitation table set to 36.5°C. The primary outcome was axillary temperature at admission to the NICU before transfer to a closed isolette, recorded with a digital thermometer. The secondary outcomes assessed were temperature within the target range (36.5-37.5°C), hypothermia (<36.5°C), and hyperthermia (>37.5°C). Results: All 122 infants were available for outcome analysis. The groups were comparable for birthweight, gestational age, and sex. The mean admission temperature was comparable between the 3 probe positions (mean, 95% CI): dorsum (36.7°C, 36.6-36.8), thorax (36.8°C, 36.7-36.9), and axilla (36.7°C, 36.6-36.9), p = 0.43. The proportion of infants with admission temperatures in the target range was comparable (87.2, 81.4, and 72.5% respectively), p = 0.44. Conclusion: Dorsal, thoracic, or axillary temperature probe positioning during resuscitation yield similar admission temperatures in moderately preterm infants. Further studies are required in infants below 28 weeks of gestation to determine the best practice.

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Association Between Admission Temperature and Mortality and Major Morbidity in Preterm Infants Born at Fewer Than 33 Weeks’ Gestation

et al. 2015

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for the Canadian Neonatal Network IMPORTANCE Neonatal hypothermia has been associated with higher mortality and morbidity; therefore, thermal control following delivery is an essential part of neonatal care. Identifying the ideal body temperature in preterm neonates in the first few hours of life may be helpful to reduce the risk for adverse outcomes.OBJECTIVES To examine the association between admission temperature and neonatal outcomes and estimate the admission temperature associated with lowest rates of adverse outcomes in preterm infants born at fewer than 33 weeks' gestation. DESIGN, SETTING, AND PARTICIPANTSRetrospective observational study at 29 neonatal intensive care units in the Canadian Neonatal Network. Participants included 9833 inborn infants born at fewer than 33 weeks' gestation who were admitted between January 1, 2010, and December 31, 2012.EXPOSURE Axillary or rectal body temperature recorded at admission. MAIN OUTCOMES AND MEASURESThe primary outcome was a composite adverse outcome defined as mortality or any of the following: severe neurological injury, severe retinopathy of prematurity, necrotizing enterocolitis, bronchopulmonary dysplasia, or nosocomial infection. The relationships between admission temperature and the composite outcome as well as between admission temperature and the components of the composite outcome were evaluated using multivariable analyses.RESULTS Admission temperatures of the 9833 neonates were distributed as follows: lower than 34.5°C (1%); 34.5°C to 34.9°C (1%); 35.0°C to 35.4°C (3%); 35.5°C to 35.9°C (7%); 36.0°C to 36.4°C (24%); 36.5°C to 36.9°C (38%); 37.0°C to 37.4°C (19%); 37.5°C to 37.9°C (5%); and 38.0°C or higher (2%). After adjustment for maternal and infant characteristics, the rates of the composite outcome, severe neurological injury, severe retinopathy of prematurity, necrotizing enterocolitis, bronchopulmonary dysplasia, and nosocomial infection had a U-shaped relationship with admission temperature (α > 0 [P < .05]). The admission temperature at which the rate of the composite outcome was lowest was 36.8°C (95% CI, 36.7°C-37.0°C). Rates of severe neurological injury, severe retinopathy of prematurity, necrotizing enterocolitis (95% CI, 36.3°C-36.7°C), bronchopulmonary dysplasia, and nosocomial infection (95% CI, 36.9°C-37.3°C) were lowest at admission temperatures ranging from 36.5°C to 37.2°C. CONCLUSIONS AND RELEVANCEThe relationship between admission temperature and adverse neonatal outcomes was U-shaped. The lowest rates of adverse outcomes were associated with admission temperatures between 36.5°C and 37.2°C.

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Axillary and rectal thermometry in the newborn: do they agree?

Cited by 25 publications

References 10 publications

Using axillary temperature to approximate rectal temperature in newborns

Using axillary temperature to approximate rectal temperature in newborns

Temperature Probe Placement during Preterm Infant Resuscitation: A Randomised Trial

Association Between Admission Temperature and Mortality and Major Morbidity in Preterm Infants Born at Fewer Than 33 Weeks’ Gestation

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