Accuracy of Infrared Thermography for Detecting Febrile Critically Ill Patients

Accuracy of Infrared Thermography for Detecting Febrile Critically Ill Patients: a Prospective Cohort Study

Accurate determination of critically ill patient of being febrile or not is an essential part of management critically ill patients as it prompt investigating the underlying cause and initiating therapeutic action.

Pulmonary artery catheter thermistor is considered the gold standard for temperature measurement . Central non-vascular thermometer such as esophageal, bladder and rectal thermometer showed excellent correlation and agreement with pulmonary artery catheter thermistor and has been accepted as alternative methods for core body temperature assessment. However, those methods are invasive and cannot be tolerated in conscious patients. Peripheral thermometer such as oral, axillary and tympanic membrane thermometer are either impractical in unconscious patient and/or carry the risk of trauma and infection.

Infrared thermography (IRT) is a non-contact and non-invasive imaging approach that enable real-time estimation of body temperature by detecting infrared emission. IRT had been used for screening for mass detection of febrile patients at airport at times of infectious disease outbreak. In adult population, IRT showed good accuracy in detecting febrile patients in emergency department; however, those studies used 37.7⁰ C as the fever threshold and the reference standard was either oral 6 or tympanic membrane thermometer. No studies to the best of our knowledge had evaluated the IRT accuracy in detecting fever in critically ill patients using esophageal thermometer as a reference method.

Study Overview

• Status: Completed
• Conditions: Temperature Monitoring

Detailed Description

The enrolled patient will be sedated according to the ICU protocol. A calibrated esophageal thermometer will be inserted by the attending intensivist through the nostril or oral cavity into the lower third of the esophagus to approximately 10-20 cm.

IRT will be performed using FLIR C2 compact thermal camera. The focal length of the thermal camera will be adjusted at 0.5 meter from the patient head. scanning will conducted over a period of 10-seconds. The researcher will record the highest reading obtained from medial canthus. No cold fomentations will be applied to the head nor the axilla of the patient for 30 minutes at least before measuring IRT.

FLIR C2 thermal camera will be calibrated before use to eliminate the effect of the ambient room temperature.

The researcher of will obtain the IRT temperature will be blinded to the esophageal probe reading.

• Study Type: Observational
• Enrollment (Actual): 135

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11562
    • Kasr Alaini hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Critically ill intubated adult patients (>18 years)

Description

Inclusion Criteria:

• Critically ill intubated adult patients (>18 years)

Exclusion Criteria:

• Patients with condition that preclude the application of esophageal thermometer such as esophageal varices, diverticulum, stenosis and malignancy
• patients with eye pathology as inflammation or malignancy which would interfere with the interpretation of the IRT reading,
• Pregnant women.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accuracy of IRT to detect fever (≥38.3⁰C).	Accuracy of IRT to detect fever (≥38.3⁰C) measured by esophageal thermometer	from focusing the camera on the patients face for 10 seconds

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation between IRT temperature readings and the simultaneous esophageal thermometer reading	degree Celsius	from focusing the camera on the patients face for 10 seconds
Bias and agreement in IRT temperature readings and the simultaneous esophageal thermometer reading	degree Celsius	from focusing the camera on the patients face for 10 seconds
Comparison the accuracy of IRT and axillary temperature in detecting fever	Accuracy to detect fever (≥38.3⁰C) measured by esophageal thermometer	from focusing the camera on the patients face for 10 seconds
Comparison the accuracy of IRT and tympanic membrane temperature in detecting fever	Accuracy to detect fever (≥38.3⁰C) measured by esophageal thermometer	from focusing the camera on the patients face for 10 seconds

Collaborators and Investigators

• Sponsor: Kasr El Aini Hospital
• Investigators: Study Director: Ahmed M Hasanin, M.D, Cairo University

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 1, 2020
• Primary Completion (ACTUAL): January 1, 2021
• Study Completion (ACTUAL): January 1, 2021

Study Registration Dates

• First Submitted: September 26, 2020
• First Submitted That Met QC Criteria: September 26, 2020
• First Posted (ACTUAL): October 1, 2020

Study Record Updates

• Last Update Posted (ACTUAL): February 23, 2021
• Last Update Submitted That Met QC Criteria: February 21, 2021
• Last Verified: February 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Critical Illness
• Other Study ID Numbers: MS-102-2020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No