[Small premature infants do not tolerate axillary temperature measurement any better than rectal measurement. Study of the effect of axillary and rectal temperature measurement on vital parameters and cerebral hemodynamics and oxygenation].

BACKGROUND

Aim of this study was to assess, by use of monitoring parameters and near infrared spectroscopy (NIRS), whether premature infants tolerate axillary temperature measurement better than rectal.

METHODS

Twenty-one infants were studied. Birth weight was 540-1680 g (median 840 g), weight at the time of investigation 470-1500 g (Median 920 g), gestational age 24-31 weeks (median 29 weeks), age at time of investigation 4-25 days (median 11 days). Four pairs of axillary/rectal temperatures were taken in every infant. Heart rate and oxygen saturation were monitored. Using NIRS cerebral oxygenated and deoxygenated hemoglobin were measured and total cerebral hemoglobin and the cerebral oxygenation index were calculated.

RESULTS

Mean heart rate increased slightly but significantly from baseline during axillary and rectal temperature measurement (axillary: +6/min (+/- 7); p < 0.0001; rectal: +4/min (+/- 6); p < 0.0001). Peak increase in heart rate was significantly higher during axillary than during rectal temperature measurement (axillary: +18/min (+/- 10); rectal: +14/min (+/- 8); axillary versus rectal: p = 0.02). There was no difference in the number of measurements during which oxygen saturation dropped intermittently below 88% (rectal: 21% of measurements; axillary: 20% of measurements). NIRS parameters were not significantly different between axillary and rectal measurements: cerebral oxygenated hemoglobin and the oxygenation index showed a decrease in cerebral oxygenation during both, axillary and rectal measurement.

CONCLUSIONS

Axillary temperature measurement is not better tolerated than rectal in premature infants.