Peripheral perfusion parameters: a) Central to toe temperature gradient (Tc-toe), where central temperature was obtained from the pulmonary artery catheter, and toe temperature from the ventral face of the great toe of the right foot.
However, central-to-toe temperature gradient was significantly larger and knee-to-room and toe-to-room temperature gradients were significantly lower in the deaths from MOF group in comparison with survivors.
Central-to-toe temperature differences that we observed were in the same range than data reported in the Lima's study with a median central-to-toe temperature gradient of 12.5 13.8] °C.8] °C in the septic shock group and 6.9 12.0] °C.0] °C in patients with severe sepsis.
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).
This suggests that room-to-toe temperature gradient reflects more the peripheral tissue perfusion than the global hemodynamic status and also suggests that it could replace mottling score or CRT in patients with dark skin.
In a small population of patients with severe sepsis and septic shock, Hernandez et al. recently described that an early recovery of both CRT and central-to-toe temperature gradient at H6 was predictive of lactate normalization at H24 [22].
These range from clinical parameters such as skin mottling [10], toe temperature [11], or near-infrared spectroscopy [12] to the direct measurement of the flow of blood cells through the venules and capillaries through laser Doppler measurements [13] and more recently, capillary microscopy [14 17].
In the real world, for example, we might presume that the system would be ill advised to use big toe temperature as a cue for apparent depth between two objects; any correlation is presumably due to chance.
Tp, peripheral toe temperature.
It was calculated by using the following formula: baseline ICU lactate (hour 0) minus lactate at hour 6, divided by baseline ICU lactate, then multiplied by 100. 3. Peripheral perfusion parameters: a) Central to toe temperature gradient (Tc-toe), where central temperature was obtained from the pulmonary artery catheter, and toe temperature from the ventral face of the great toe of the right foot.
