title: Axillary and tympanic membrane temperature measurements are unreliable early after cardiopulmonary bypass.
abstract: OBJECTIVE
  Inaccurate measurements of body temperature following cardiopulmonary bypass may be associated with serious complications. The purpose of this study was to determine whether axillary and tympanic temperature measurements correlate with the urinary bladder temperature in the early postcardiac surgery period.
  
  
  METHODS
  Forty-nine adult patients who underwent cardiac surgery under cardiopulmonary bypass at our institution were prospectively studied. Urinary bladder, right axillary, right tympanic and left tympanic temperature measurements were simultaneously recorded at 0, 6, 12 and 18 h following cardiopulmonary bypass. Patients had one to four sets of recordings and a total of 629 temperature measurements were recorded. The mean difference (bias) between the bladder and each of the other methods and limits of agreement were calculated using Bland and Altman method.
  
  
  RESULTS
  The mean core body temperature recorded from the bladder on admission to the intensive care unit was 36.4 degrees C. After 6, 12 and 18 h the mean core body temperature was 37.4 degrees C (range: 35.2-39.0), 37.5 degrees C and 37.45 degrees C, respectively. The mean differences (bias) between the bladder temperature and the other three methods were: left tympanic, 0.65 degrees C (95% CI: -0.24 to 1.58); right tympanic, 0.57 degrees C (95% CI: -0.48 to 1.63) and right axillary, 0.55 degrees C (95% CI: -0.27 to 1.36).
  
  
  CONCLUSIONS
  The axilla and tympanic membrane are unreliable sites for core body temperature measurement early after cardiopulmonary bypass in adult patients and clinical decisions should be based on more reliable methods.
authors.affiliation: University Hospital Coventry NHS Trust, Department of Cardiothoracic Surgery, Coventry, UK. tanveerkhan_a@yahoo.com
authors.forename: T A
authors.initials: TA
authors.lastname: Khan
authors.forename: H A
authors.initials: HA
authors.lastname: Vohra
authors.forename: S
authors.initials: S
authors.lastname: Paul
authors.forename: M D
authors.initials: MD
authors.lastname: Rosin
authors.forename: R L
authors.initials: RL
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001366:Axillary Artery / Q000502:physiology*; D001367:Axillary Vein / Q000502:physiology*; D001831:Body Temperature / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D014432:Tympanic Membrane / Q000502:physiology*; D001743:Urinary Bladder