Temperature measured at the axilla compared with rectum in children and young people: systematic review

Objective To evaluate the agreement between temperature measured at the axi lla and rectum in children and young people. Design A systematic review of studies comparing temperature measured at the axilla (test site) with temperature measured at the rectum (reference site ) using the same type of measuring device at both sites in each patient. De vices were mercury or electronic thermometers or indwelling thermocouple pr obes. Studies reviewed 40 studies including 5528 children and young people from b irth to Is years. Data extraction Difference in temperature readings at the axilla and rectum . Results 20 studies (n = 3201 (58%) participants) had sufficient data to be included in a meta-analysis. There was significant residual heterogeneity i n both mean differences and sample standard deviations within the groups us ing different devices and within age groups. The pooled (random effects) me an temperature difference (rectal minus axillary temperature) for mercury t hermometers was 0.25 degrees C (95% limits of agreement -0.15 degrees C to 0.65 degrees C) and for electronic thermometers was 0.85 degrees C (-0.19 d egrees C to 1.90 degrees C). The pooled (random effects) mean temperature d ifference (rectal minus axillary; temperature) for neonates was 0.17 degree s C (-0.15 degrees C to 0.50 degrees C) and for older children and young pe ople was 0.92 degrees C (-0.15 degrees C to 1.98 degrees C). Conclusions The difference between temperature readings at the axilla and r ectum using either mercury or electronic thermometers shelved wide variatio n across studies. This has implications for clinical situations where tempe rature needs to be measured with precision.