To validate intraoperative pulse hemoglobin (SpHb) measurements in anesthetized patients with large forearm temperature – fingertip temperature gradients.
In another study, patients with abnormal perfusion had a higher forearm-to-fingertip temperature gradient and a higher central-to-toe temperature difference (10 ± 4.1 vs 6.5 ± 3.4 °C, P < 0.001).
Lima et al. [30] described that nitroglycerin infusion improved forearm-to-fingertip temperature gradient in few patients with acute circulatory failure from 3.3 ± 0.7 to 0.7 ± 0.6 °C (P < 0.05).
More recently, Elofsson et al.[10] examined heart rate, respiration, fingertip temperature and skin conductance on patients who had undergone EMDR-treatment following Shapiro's protocol.
Four patients had to be excluded due to low baseline fingertip temperature at the start of the DTM assessment.
For the DTM measurements, we excluded tests with a baseline fingertip temperature below 27°C in reference to a previous study indicating that it would provide an unreliable temperature rebound (TR) value due to predisposed vasoconstriction in a relatively cold finger [ 10].
CI, confidence interval; StO2, tissue oxygen saturation; Tskin-diff, forearm-to-fingertip skin temperature gradient.
Peripheral perfusion assessment consisted of capillary refill time (CRT), peripheral perfusion index (PPI) and forearm-to-fingertip skin temperature gradient (Tskin-diff).
aAUC, Area under the receiver operating characteristic curve; CI, Confidence interval; D0, Directly after surgery; D1, First postoperative day; D2, Second postoperative day; D3, Third postoperative day; PPI, Peripheral perfusion index; Tskin-diff, Forearm-to-fingertip skin temperature gradient.
Abnormal peripheral perfusion is defined as at least one abnormal peripheral perfusion variable capillary refill time >4.5 seconds, peripheral perfusion index <1.4 or a forearm-to-fingertip skin temperature gradient >2°C.
