{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T20:39:43Z","timestamp":1770496783129,"version":"3.49.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>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 [\u00b0C]) were assessed at the time of admission, 6- and 12\u00a0h 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).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>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\u00a0h showed good ability in predicting in-hospital mortality with AUC (95% confidence interval) of 0.72 (0.58\u20130.84) and a negative predictive value of 70% at toe temperature of \u2264\u200925.5\u00a0\u00b0C. Both serum lactate and CRT showed good ability to predict in-hospital mortality at all timepoints with high positive predictive values (&gt;\u200990%) at cut-off value of &gt;\u20092.5\u20134.3 mmol\/L for the serum lactate and &gt;\u20093-4.2\u00a0s for the CRT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>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\u2009&gt;\u200925.5\u00a0\u00b0C, measured using infrared thermal imaging can exclude in-hospital mortality with a negative predictive value of 70%.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-024-02486-w","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T06:01:47Z","timestamp":1711000907000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The use of thermal imaging for evaluation of peripheral tissue perfusion in surgical patients with septic shock"],"prefix":"10.1186","volume":"24","author":[{"given":"Ahmed","family":"Hasanin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radwa","family":"Fekry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maha","family":"Mostafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahar","family":"Kasem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amany","family":"Eissa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heba","family":"Raafat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"2486_CR1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1056\/NEJMra1208943","volume":"369","author":"J-L Vincent","year":"2013","unstructured":"Vincent J-L, De Backer D. Circulatory shock. N Engl J Med. 2013;369:1726\u201334.","journal-title":"N Engl J Med"},{"key":"2486_CR2","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s40560-017-0220-5","volume":"5","author":"A Hasanin","year":"2017","unstructured":"Hasanin A, Mukhtar A, Nassar H. Perfusion indices revisited. J Intensive care. 2017;5:24.","journal-title":"J Intensive care"},{"key":"2486_CR3","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1097\/CCM.0b013e3182742e8b","volume":"41","author":"D De Backer","year":"2013","unstructured":"De Backer D, Donadello K, Sakr Y, Ospina-Tascon G, Salgado D, Scolletta S, et al. Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med. 2013;41:791\u20139.","journal-title":"Crit Care Med"},{"key":"2486_CR4","doi-asserted-by":"publisher","first-page":"R10","DOI":"10.1186\/cc9410","volume":"15","author":"I Baelani","year":"2011","unstructured":"Baelani I, Jochberger S, Laimer T, Otieno D, Kabutu J, Wilson I, et al. Availability of critical care resources to treat patients with severe sepsis or septic shock in Africa: a self-reported, continent-wide survey of anaesthesia providers. Crit Care. 2011;15:R10.","journal-title":"Crit Care"},{"key":"2486_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13613-019-0511-1","volume":"9","author":"G Hariri","year":"2019","unstructured":"Hariri G, Joffre J, Leblanc G, Bonsey M, Lavillegrand J-RR, Urbina T, et al. Narrative review: clinical assessment of peripheral tissue perfusion in septic shock. Ann Intensive Care. 2019;9:1\u20139.","journal-title":"Ann Intensive Care"},{"key":"2486_CR6","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1186\/s13054-023-04751-9","volume":"27","author":"M Jacquet-Lagr\u00e8ze","year":"2023","unstructured":"Jacquet-Lagr\u00e8ze M, Pernollet A, Kattan E, Ait-Oufella H, Chesnel D, Ruste M, et al. Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis. Crit Care. 2023;27:473.","journal-title":"Crit Care"},{"key":"2486_CR7","doi-asserted-by":"crossref","unstructured":"Bourcier S, Pichereau C, Boelle PY, Nemlaghi S, Dub\u00e9e V, Lejour G et al. Toe-to-room temperature gradient correlates with tissue perfusion and predicts outcome in selected critically ill patients with severe infections. Ann Intensive Care. 2016;6.","DOI":"10.1186\/s13613-016-0164-2"},{"key":"2486_CR8","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/s10877-014-9599-x","volume":"29","author":"M Mo\u017ca\u0144ski","year":"2015","unstructured":"Mo\u017ca\u0144ski M, Rustecki B, Kalicki B, Jung A. Thermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report. J Clin Monit Comput. 2015;29:297\u20139.","journal-title":"J Clin Monit Comput"},{"key":"2486_CR9","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s10877-017-0026-y","volume":"32","author":"AA Bruins","year":"2018","unstructured":"Bruins AA, Kistemaker KRJ, Boom A, Klaessens JHGM, Verdaasdonk RM, Boer C. Thermographic skin temperature measurement compared with cold sensation in predicting the efficacy and distribution of epidural anesthesia. J Clin Monit Comput. 2018;32:335\u201341.","journal-title":"J Clin Monit Comput"},{"key":"2486_CR10","doi-asserted-by":"crossref","unstructured":"Nagori A, Dhingra LS, Bhatnagar A, Lodha R, Sethi T. Predicting hemodynamic shock from thermal images using machine learning. Sci Rep. 2019;9.","DOI":"10.1038\/s41598-018-36586-8"},{"key":"2486_CR11","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/01.ASW.0000559613.83195.f9","volume":"32","author":"S Koerner","year":"2019","unstructured":"Koerner S, Adams D, Harper SL, Black JM, Langemo DK. Use of Thermal Imaging to identify deep-tissue pressure Injury on Admission reduces clinical and financial burdens of Hospital-Acquired pressure injuries. Adv Ski Wound Care. 2019;32:312\u201320.","journal-title":"Adv Ski Wound Care"},{"key":"2486_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ejvssr.2016.04.004","volume":"32","author":"A Peleki","year":"2016","unstructured":"Peleki A, Da Silva A. Novel use of smartphone-based Infrared Imaging in the detection of Acute Limb Ischaemia. EJVES Short Rep. 2016;32:1\u20133.","journal-title":"EJVES Short Rep"},{"key":"2486_CR13","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1001\/jama.2016.0289","volume":"315","author":"M Shankar-Hari","year":"2016","unstructured":"Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al. Developing a new definition and assessing New Clinical Criteria for septic shock. JAMA. 2016;315:775.","journal-title":"JAMA"},{"key":"2486_CR14","doi-asserted-by":"publisher","first-page":"100951","DOI":"10.1016\/j.accpm.2021.100951","volume":"40","author":"M Mostafa","year":"2021","unstructured":"Mostafa M, Helmy NA, Ibrahim AS, Elsayad M, Hasanin AM. Accuracy of infrared thermography in detecting febrile critically ill patients. Anaesth Crit Care Pain Med. 2021;40:100951.","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2486_CR15","doi-asserted-by":"publisher","first-page":"71","DOI":"10.2147\/LRA.S406057","volume":"16","author":"M Gamal","year":"2023","unstructured":"Gamal M, Hasanin A, Adly N, Mostafa M, Yonis AM, Rady A, et al. Thermal imaging to Predict failed Supraclavicular Brachial Plexus Block: a prospective observational study. Local Reg Anesth. 2023;16:71\u201380.","journal-title":"Local Reg Anesth"},{"key":"2486_CR16","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.jcrc.2020.08.022","volume":"60","author":"H Amson","year":"2020","unstructured":"Amson H, Vacheron CH, Thiolliere F, Piriou V, Magnin M, Allaouchiche B. Core-to-skin temperature gradient measured by thermography predicts day-8 mortality in septic shock: a prospective observational study. J Crit Care. 2020;60:294\u20139.","journal-title":"J Crit Care"},{"key":"2486_CR17","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1053\/j.jvca.2021.05.018","volume":"36","author":"S Kimura","year":"2022","unstructured":"Kimura S, Butt W. Core-Peripheral temperature gradient and skin temperature as predictors of major adverse events among postoperative Pediatric Cardiac patients. J Cardiothorac Vasc Anesth. 2022;36:690\u20138.","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2486_CR18","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s13054-019-2478-6","volume":"23","author":"J Vincent","year":"2019","unstructured":"Vincent J, Jones G, David S, Olariu E, Cadwell KK. Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis. Crit Care. 2019;23:196.","journal-title":"Crit Care"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-024-02486-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-024-02486-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-024-02486-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T06:01:53Z","timestamp":1711000913000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-024-02486-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,21]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2486"],"URL":"https:\/\/doi.org\/10.1186\/s12871-024-02486-w","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,21]]},"assertion":[{"value":"7 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This randomized controlled, double-blinded study was conducted in Cairo University Hospital after institutional ethics committee approval (MD-24-2021). This study was performed in line with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient before the enrolment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"No potential conflict of interest relevant to this article was reported.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"109"}}