Using axillary temperature to approximate rectal temperature in newborns

Lantz, Björn; Ottosson, Cornelia

doi:10.1111/apa.13009

Cited by 16 publications

(15 citation statements)

References 22 publications

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“…Third, body temperature was not collected using uniform methods, and we did not register the site at which the temperature was measured, which might have influenced the precision of the temperature. Recent studies have shown differences between axillary and rectal measurements but have also indicated that the differences are smaller in infants of younger gestational ages [29-32]. Fourth, 243 infants (5.2%) had missing admission temperatures, and 300 infants (6.4%) were excluded due to transfer to other hospitals, which could have potentially biased the results.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

et al. 2019

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BackgroundPreterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C.PurposeWe aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities.MethodsA cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed.ResultsThe mean admission temperature was 36.1°C±0.6°C, with a range of 31.9°C to 38.4°C. Approximately 74.1% of infants had an admission hypothermia of <36.5°C. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5°C–37.5°C and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04–1.83), 1.44 (95% CI, 1.05–1.97) and 1.86 (95% CI, 1.22–2.82) for infants with admission temperatures of 36.0°C–36.4°C, 35.0°C–35.9°C, and <35.0°C, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy.ConclusionA large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

et al. 2019

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“…Methods of thermometry (rectal, axillary or tympanic sites) were not standardized nor consistently recorded in the patient charts. Although there may be a 0.3-0.6C difference between rectal and tympanic or axillary thermometry, 12,13 it is largely impractical and unacceptable to perform rectal thermometry in older pediatric patients, and relatively contraindicated in neutropenic oncology patients, and thus is not the routine practice at our hospital, except in some patients less than three months of age. Blood cultures without collection times comprised 13% of all cultures collected, and their time of receipt at the laboratory was used to approximate the collection time.…”

Section: A C C E P T E Dmentioning

confidence: 99%

Diagnostic Yield of Timing Blood Culture Collection Relative to Fever

Kee

Chinnappan

Nair

et al. 2016

Pediatric Infectious Disease Journal

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“…We found that environmental factors did not significantly affect the differences in BT measurements. Similarly, Lantz and Ottosson [16] found that the difference between AT and RT measurements was not influenced by the presence of incubator care. In contrast, Helder et al [17] found that the temperature measurement differences in infants cared for in an incubator were more significant than those in infants cared for in a crib.…”

Section: Discussionmentioning

confidence: 83%

“…This group also found that the difference seemed to increase with increasing postnatal age. Lantz and Ottosson [16] also compared temperature measurements from the axilla and rectum in infants, and found that infants aged <37, 37-42, and >42 weeks had higher RT measurements by 0.33°C, 0.43°C, and 0.48°C, respectively. Hence, the measurement of AT should not replace the gold standard RT, though it may be useful for preterm infants less than 32 weeks, while recognizing its clinical limitations.…”

Section: Discussionmentioning

confidence: 99%

Comparing Axillary and Rectal Temperature Measurements in Very Preterm Infants: A Prospective Observational Study

et al. 2021

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Purpose: The agreement between axillary temperature (AT) and rectal temperature (RT) measurements has not been well established in preterm infants. Therefore, our study aimed to evaluate the agreement between AT and RT measurements in very preterm infants. Methods: Preterm infants <32 weeks of gestational age were prospectively included. The infants’ body temperature (BT) was measured twice a day from day 1 to day 6. A paired t-test and the Bland-Altman method were used to analyze the difference between the AT and RT. A linear regression model was used to explore the effects of environmental factors on the differences of BT between the axillary and rectal measurements and to calibrate the RT according to the AT. Results: Eighty infants each underwent 6 paired axillary and rectal measurements. The gestational age varied from 22 to 31 weeks (mean 28 weeks). The birth weight varied from 302 to 1,770 g (mean 1,025 g). The AT was significantly lower than the RT. The difference between the RT and AT significantly increased with increasing RT. The AT and RT demonstrated poor agreement overall; however, the RT can be estimated using the AT with the following equation: RT = −4.033 + 1.116 × AT. Environmental factors, including the incubator temperature, incubator humidity, phototherapy, and application of invasive mechanical ventilation did not affect the differences between the AT and RT measurements. Conclusion: AT measurements cannot be interchangeably used with RT measurements in very preterm infants.

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Using axillary temperature to approximate rectal temperature in newborns

Cited by 16 publications

References 22 publications

Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network

Diagnostic Yield of Timing Blood Culture Collection Relative to Fever

Comparing Axillary and Rectal Temperature Measurements in Very Preterm Infants: A Prospective Observational Study

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