Supplementary Material for: Concordance between tympanic and enteral temperature for early fever detection in hematologic intensive care unit patients: a prospective study

Introduction: Early detection of fever is crucial in neutropenic patients. Lack of precision in body temperature measurement can occur with peripheral site measurements. Furthermore, intermittent temperature monitoring may result in a delay in fever detection.
Methods: We conducted a prospective study in hematological intensive care unit (HICU) patients receiving autologous stem cell transplant or intensive chemotherapy in order to compare tympanic and enteral temperature measured by an ingested electronic pill (BodyCap ®, France).
Results: Twenty-six patients ingested at least one capsule with a total of 218 days of tympanic and enteral simultaneous measurement. In 12% of these measurements, we identified a difference over 0.5°C between the left ear vs. right ear measurements. Enteral temperature was usually higher than the tympanic one (p<0.0001) with 14% of the measurements that were discordant with higher enteral temperature and 1.9% that were discordant with higher tympanic temperature. Febrile episodes were detected with the ingestible pill on average almost 24 hours earlier than with the tympanic measurement. Early capsule evacuation occurred in 20.4% of the cases, mainly because of diarrhea, a frequent adverse event in these patients. Patients were satisfied with capsule ingestion according to a questionnaire.
Conclusions: In this prospective trial (TEMPET), we demonstrated that enteral temperature measured by an ingested pill is feasible in HICU and detect fever earlier than tympanic routine measurements. Digestive symptoms related to hematological disease and/or treatments are limiting factors for its generalized usage.

引言：发热的早期检测对中性粒细胞减少症患者至关重要。外周部位测量可能导致体温测量精度不足。此外，间歇性体温监测可能延误发热的检测。
方法：我们在接受自体干细胞移植或强化化疗的血液科重症监护室（HICU）患者中开展了一项前瞻性研究，旨在比较鼓膜温度与通过可吞咽电子药丸（BodyCap ®，法国）测量的肠道温度。
结果：26例患者至少吞服了1粒胶囊，共完成218天的鼓膜温度与肠道温度同步测量。在12%的测量中，左耳与右耳的测量值差异超过0.5°C。肠道温度通常高于鼓膜温度（p<0.0001）：14%的测量结果显示肠道温度更高，1.9%的结果显示鼓膜温度更高。可吞咽药丸检测到发热事件的时间平均比鼓膜测量早近24小时。20.4%的病例出现胶囊提前排出，主要原因是腹泻——这是此类患者常见的不良事件。根据问卷调查，患者对吞服胶囊的体验表示满意。
结论：在这项前瞻性试验（TEMPET）中，我们证实，通过可吞咽药丸测量肠道温度在HICU患者中具有可行性，且比常规鼓膜测量能更早检测到发热。与血液系统疾病及/或治疗相关的消化道症状是其广泛应用的限制因素。