Continuous fever Monitoring: Why does it matter?
We humans, like all other mammals, are endothermic creatures (i.e warm-blooded). This means that we have an internal mechanism to maintain our body’s core temperature within a tightly controlled range, that is optimal for the body to function.
In clinical practice, measuring body temperature is of immense diagnostic value to a physician. While in most cases, just the presence or absence of fever is really significant, there are numerous examples where precise and consistent monitoring of body temperature is essential to making a diagnosis eg. diseases like malaria and kala-azar are noted for their unique and characteristic fever curves. While malaria has an intermittent, paroxysmal fever pattern, Kala Azar displays a double quotidian pattern, where sharp increases, along with rigours, are seen twice a day.
“Temperature tracking is widely discussed as a method to track fertility, in women. Studies indicate that during a woman’s ovulation phase, increased progesterone levels may contribute to a slight increase in Basal Body Temperature (BBT).”
Continuous temperature measurement has the potential to offer us unprecedented insights into fevers and could prove to be very useful in establishing the cause and nature of a fever. Recording trends in body temperature over time, allows us to reliably understand the intensity and progression of a fever, note nocturnal/diurnal variations and also, evaluate treatment effectiveness. More than just identifying fever, this data could allow a physician to precisely understand the onset and prognosis of the fever. This could be of tremendous help in formulating the most optimal treatment strategy for a particular situation.
Where is continuous fever management absolutely indispensable?
Steady and accurate monitoring of fever and fever patterns is especially important in the following patient groups and the respective clinical scenarios. A seamless, non-invasive continuous temperature measurement technology could massively benefit such situations.
Continuous and accurate monitoring of fever patterns is of vital importance in neonates and infants. In infants under 3 months of age, a temperature over 38°C indicates a serious bacterial infection in 3-15% of patients. In children undergoing chemotherapy or in children with sickle cell anaemia, severe bacterial infections are life-threatening and often, emergency admission and treatment with antibiotics are started just on the basis of fever.
The elderly, much like children, are very prone to disorders of thermoregulation. They have a compromised ability to alter their body’s metabolic rate, making it hard for them to adjust to external temperature changes. They also have lower intravascular volume and reduced cardiac capacity, which further compounds the problem.
“People at either end of the age spectrum (children and the elderly) are high-risk groups for thermoregulatory disorders. They usually lack muscle mass and the shivering reflex, which makes sudden temperature fluctuations extremely dangerous, especially during illness.”
Continuous fever monitoring plays a huge role in diagnosing and managing elderly patients. A physician must always be on the lookout for signs of sepsis, in elderly patients with an infectious disease or neurological condition. For instance, Studies show that the core temperature, in the first 24 hours of infection is a reliable predictor of sepsis and mortality, in elderly patients.
Fevers are a very ominous sign during pregnancies. Although something as trivial and harmless as a common cold or the flu could cause a fever, it could also be a sign of extremely serious infections like puerperal sepsis or chorioamnionitis, which are dangerous for both the mother and the foetus. Accurate and sustained temperature readings during pregnancy can help ensure that expert care is sought when needed. They can alert us to unfavourable developments and pre-empt any risk to mother or child.
4. Critical illnesses:
Temperature monitoring is an essential part of in-patient care, for any serious illness. Especially in the aftermath of neurological diseases such as Traumatic Brain Injury or a Stroke, a fever usually foretells disastrous outcomes and so, continuous measurement helps provide better and more responsive care. E.g Epilepsy and febrile seizures are basically differentiated only by the presence or absence of a fever. Therefore, the initial treatment course is determined solely through temperature data.
Extremely precise measurement of core temperature is employed over the course of surgeries, to monitor the effects of the anesthesia. Operating room emergencies, almost invariably, involve rapid fluctuations (both increase and decrease) in temperature. Any volatility in the temperature is treated as an emergency and precautions are usually on kept on hand to deal with them, if they arise.
Our technology capabilities today, are driving significant changes in how healthcare is approached. Astronomically vast amounts of data can now be processed with ridiculous ease and reliability. The future of healthcare, without a doubt, lies in harnessing our information processing might towards ensuring better treatment strategies and outcomes.
Continuous temperature monitoring promises to give us a window into valuable information on the inner workings of the body. Along with other cutting edge technologies, it augurs a future where it would be possible to deliver healthcare that is more precise and patient-centric.