Core-to-skin temperature gradient measured by thermography predicts day-8 mortality in septic shock: A prospective observational study

Amson, Harry; Vacheron, Charles-Hervé; Thiollière, Fabrice; Piriou, Vincent; Magnin, Mathieu; Allaouchiche, Bernard

doi:10.1016/j.jcrc.2020.08.022

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…Furthermore, thermal camera has the advantage of avoiding close contact with the patients which is warranted in the peri-pandemic era. Unlike our findings, a previous study by Amson et al had reported good predictive properties for thermal imaging in predicting 8-day patient outcomes [ 16 ]. Several reasons might explain the difference between our study and Amson et al study such as the different primary outcome.…”

Section: Discussioncontrasting

confidence: 99%

The use of thermal imaging for evaluation of peripheral tissue perfusion in surgical patients with septic shock

Hasanin,

Fekry,

Mostafa

et al. 2024

BMC Anesthesiol

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Background In this study, we aimed to evaluate the ability of central-to-peripheral temperature gradients using thermal imaging to predict in-hospital mortality in surgical patients with septic shock. Methods This prospective observational study included adult patients with septic shock admitted to the intensive care unit postoperatively. Serum lactate (in mmol/L), capillary refill time (CRT) (in seconds), toe (peripheral) and canthal (central) temperature by infrared thermography and the corresponding room temperature in (Celsius [°C]) were assessed at the time of admission, 6- and 12 h after admission. The canthal-toe and room-toe temperature gradients were calculated. According to their final outcomes, patients were divided into survivors and non-survivors. The ability of canthal-toe temperature gradient (primary outcome), room-toe temperature gradient, toe temperature, serum lactate and CRT, measured at the prespecified timepoints to predict in-hospital mortality was analyzed using the area under receiver operating characteristic curve (AUC). Results Fifty-six patients were included and were available for the final analysis and 41/56 (73%) patients died. The canthal-toe and room-toe temperature gradients did not show significant accuracy in predicting mortality at any timepoint. Only the toe temperature measurement at 12 h showed good ability in predicting in-hospital mortality with AUC (95% confidence interval) of 0.72 (0.58–0.84) and a negative predictive value of 70% at toe temperature of ≤ 25.5 °C. Both serum lactate and CRT showed good ability to predict in-hospital mortality at all timepoints with high positive predictive values (> 90%) at cut-off value of > 2.5–4.3 mmol/L for the serum lactate and > 3-4.2 s for the CRT. Conclusion In post-operative emergency surgical patients with septic shock, high serum lactate and CRT can accurately predict in-hospital mortality and were superior to thermal imaging, especially in the positive predictive values. Toe temperature > 25.5 °C, measured using infrared thermal imaging can exclude in-hospital mortality with a negative predictive value of 70%.

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Section: Discussioncontrasting

confidence: 99%

The use of thermal imaging for evaluation of peripheral tissue perfusion in surgical patients with septic shock

Hasanin,

Fekry,

Mostafa

et al. 2024

BMC Anesthesiol

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“…Raimer et al ( 31 ) reported that a normal CRT less than or equal to 2 seconds could be predictive of central venous oxygen saturation greater than or equal to 70%. Amson et al ( 32 ) reported that CRT was correlated with core-to-index finger temperature gradient in septic shock.…”

Section: Discussionmentioning

confidence: 99%

Association of Sublingual Microcirculation Parameters and Capillary Refill Time in the Early Phase of ICU Admission*

Huang

Xiang

et al. 2023

Critical Care Medicine

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Objectives: This observational study was conducted to investigate capillary refill time (CRT) during the early phase of ICU admission in relationship with microvascular flow alteration and outcome in critically ill patients. Design: Prospective, observational, pilot study. Setting: ICU in a university hospital. Patients: Two hundred eighty-two critically ill adult patients admitted to the ICU. Interventions: None. Measurements and Main Results: All patients underwent simultaneous measurements by CRT and sidestream dark field imaging within 24 hours of ICU admission. Other clinical data such as demographic characteristics, hemodynamics, laboratory values, treatment, and physiologic parameters were also included simultaneously. Microcirculatory measurements were performed at 10.2 ± 5.7 hours after ICU admission. Of the 282 included patients, 106 (37.6%) were female, the median (interquartile range) age was 63 years (53–74 yr), and the median Sequential Organ Failure Assessment (SOFA) score was 5 (2–7). The primary finding was the association between CRT and simultaneous the condition of peripheral circulation (microvascular flow index [MFI]: r = –0.4430, p < 0.001; proportion of perfused vessels: r = –0.3708, p < 0.001; heterogeneity index: r = 0.4378, p < 0.001; perfused vessel density: r = –0.1835, p = 0.0020; except total vessel density: p = 0.9641; and De Backer score: p = 0.5202) in critically ill patients. In addition, this relationship was also maintained in subgroups. Microcirculatory flow abnormalities, 28-day mortality, and SOFA score appeared to be more severe for increasing CRT. In a multivariable analysis, prolonged CRT was independently associated with microvascular flow abnormalities (MFI < 2.6; odds ratio [OR], 1.608; 95% CI, 2.1–10.2; p < 0.001). Similarly, multivariable analysis identified CRT as an independent predictor of 28-day mortality (OR, 1.296; 95% CI, 1.078–1.558; p = 0.006). Conclusions: In our ICU population, a single-spot prolonged CRT was independently associated with abnormal microcirculation and increased mortality.

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“…stay ED NO NO 3 Amson et al . [ 54 ] Vital status D28 ICU YES YES 3 Magnin et al . [ 55 ] Vital status D14 ICU YES YES 3 Morocho et al .…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis

Jacquet-Lagrèze,

Pernollet,

Kattan

et al. 2023

Crit Care

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Purpose Acute circulatory failure leads to tissue hypoperfusion. Capillary refill time (CRT) has been widely studied, but its predictive value remains debated. We conducted a meta-analysis to assess the ability of CRT to predict death or adverse events in a context at risk or confirmed acute circulatory failure in adults. Method MEDLINE, EMBASE, and Google scholar databases were screened for relevant studies. The pooled area under the ROC curve (AUC ROC), sensitivity, specificity, threshold, and diagnostic odds ratio using a random-effects model were determined. The primary analysis was the ability of abnormal CRT to predict death in patients with acute circulatory failure. Secondary analysis included the ability of CRT to predict death or adverse events in patients at risk or with confirmed acute circulatory failure, the comparison with lactate, and the identification of explanatory factors associated with better accuracy. Results A total of 60,656 patients in 23 studies were included. Concerning the primary analysis, the pooled AUC ROC of 13 studies was 0.66 (95%CI [0.59; 0.76]), and pooled sensitivity was 54% (95%CI [43; 64]). The pooled specificity was 72% (95%CI [55; 84]). The pooled diagnostic odds ratio was 3.4 (95%CI [1.4; 8.3]). Concerning the secondary analysis, the pooled AUC ROC of 23 studies was 0.69 (95%CI [0.65; 0.74]). The prognostic value of CRT compared to lactate was not significantly different. High-quality CRT was associated with a greater accuracy. Conclusion CRT poorly predicted death and adverse events in patients at risk or established acute circulatory failure. Its accuracy is greater when high-quality CRT measurement is performed.

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Core-to-skin temperature gradient measured by thermography predicts day-8 mortality in septic shock: A prospective observational study

Cited by 13 publications

References 27 publications

The use of thermal imaging for evaluation of peripheral tissue perfusion in surgical patients with septic shock

The use of thermal imaging for evaluation of peripheral tissue perfusion in surgical patients with septic shock

Association of Sublingual Microcirculation Parameters and Capillary Refill Time in the Early Phase of ICU Admission*

Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis

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