‘Catching the spike and tracking the flow’: Holter-temperature monitoring in patients admitted in a general internal medicine ward

Abstract

Temperature Holter monitoring reveals fever peaks that pass otherwise unobserved. Furthermore, chronobiological and complexity analysis of the temperature profile may provide quick and easy 'hidden information', not available to conventional care.

The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis

“…Twelve studies examined the impact of continuous vital signs monitoring on clinical outcomes. Five of these were randomised controlled trials (Langhorne et al, 2010;Ochroch et al, 2006;Sulter et al, 2003;Tarassenko et al, 2005;Watkinson et al, 2006), one was a non-randomised controlled trial (Cavallini et al, 2003), three were controlled beforeand-after studies (Brown et al, 2014;Kisner et al, 2009;Taenzer et al, 2010) and three were prospective observational studies (Taenzer et al, 2014;Varela et al, 2011;Wan et al, 2004). All were single-centre studies.…”

“…Six of the selected papers focussed on continuous measurement of a single vital sign parameter: five examined continuous pulse oximetry (CPOX) alone; (Kisner et al, 2009;Ochroch et al, 2006;Taenzer et al, 2010Taenzer et al, , 2014Wan et al, 2004) one study examined continuous temperature monitoring alone. (Varela et al, 2011) Taenzer et al and Wan et al compared intermittent oxygen saturation measurements with that collected by CPOX. (Taenzer et al, 2010(Taenzer et al, , 2014Wan et al, 2004) Taenzer reported that manually recorded data was significantly higher than those recorded by CPOX, and did not reflect the patients' physiological state.…”

Effectiveness of continuous or intermittent vital signs monitoring in preventing adverse events on general wards: a systematic review and meta-analysis

“…Studies of CM were generally of medium duration, with six of the nine reviewed lasting between 6 and 23 months. Bias assessment of the nine CM studies identified potential validity and generalisability issues including cross-contamination where the same staff cared for intervention and control subjects (29); unblinded convenience sampling (31); selection of controls not directly comparable, for example from the two decades before the intervention (35); small sample sizes (28,42,44); or a small proportion (16%) of patients complying with CM for the anticipated observation period (31). In some cases, findings lost statistical significance after adjustment for potential confounders (40).…”

“…Of the five CM studies assessing impact on early detection of deterioration (Table 2), four reported significantly positive improvements, while one study (31) found no change. Benefits were found through earlier identification of abnormal physiological signs (29,42), hypoxia (28) and fever (44).…”

Development of a Novel Scheme for Long-Term Body Temperature Monitoring: A Review of Benefits and Applications

“…This issue was studied in [6]. The two main findings of this study were that conventional temperature monitoring overlooks a significant proportion of fever peaks (the new method found a mean of 0.73 more peaks than low frequency readings), and, in addition, a high-frequency sampling of temperature such as the one proposed in this paper, may reveal some otherwise hidden characteristics of thermoregulation, such as differences between tuberculosis and HIV patients.…”