{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:15:29Z","timestamp":1787670929508,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,18]],"date-time":"2023-06-18T00:00:00Z","timestamp":1687046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["1.1.1.1\/16\/A\/065"],"award-info":[{"award-number":["1.1.1.1\/16\/A\/065"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Skin temperature changes can be used to assess peripheral perfusion in circulatory shock patients. However, research has been limited to point measurements from acral parts of the body. Infrared thermography allows non-invasive evaluation of temperature distribution over a larger surface. Our study aimed to map thermographic patterns in the knee and upper thigh of 81 septic shock patients within 24 h of admission and determine the relationship between skin temperature patterns, mottling, and 28-day mortality. We extracted skin temperature measurements from zones corresponding to mottling scores and used a linear mixed model to analyze the distribution of skin temperature in patients with different mottling scores. Our results showed that the distribution of skin temperature in the anterior thigh and knee is physiologically heterogeneous and has no significant association with mottling or survival at 28 days. However, overall skin temperature of the anterior thigh and knee is significantly lower in non-survivors when modified by mottling score. No differences were found in skin temperature between the survivor and non-survivor groups. Our study shows the potential usefulness of infrared thermography in evaluating skin temperature patterns in resuscitated septic shock patients. Overall skin temperature of the anterior thigh and knee may be an important indicator of survival status when modified by mottling score.<\/jats:p>","DOI":"10.3390\/bioengineering10060729","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T03:04:40Z","timestamp":1687143880000},"page":"729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infrared Thermography Imaging for Assessment of Peripheral Perfusion in Patients with Septic Shock"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-3238","authenticated-orcid":false,"given":"Sigita","family":"Kazune","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Laboratory of Biophotonics, Institute of Atomic Physics and Spectroscopy, University of Latvia, LV-1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgars","family":"Vasiljevs","sequence":"additional","affiliation":[{"name":"Residency Development Department, University of Latvia, LV-1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasija","family":"Caica-Rinca","sequence":"additional","affiliation":[{"name":"Laboratory of Biophotonics, Institute of Atomic Physics and Spectroscopy, University of Latvia, LV-1004 Riga, Latvia"},{"name":"Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, LV-1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbignevs","family":"Marcinkevics","sequence":"additional","affiliation":[{"name":"Laboratory of Biophotonics, Institute of Atomic Physics and Spectroscopy, University of Latvia, LV-1004 Riga, Latvia"},{"name":"Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, LV-1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andris","family":"Grabovskis","sequence":"additional","affiliation":[{"name":"Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, LV-1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1007\/s00134-020-06151-x","article-title":"Incidence and Mortality of Hospital- and ICU-Treated Sepsis: Results from an Updated and Expanded Systematic Review and Meta-Analysis","volume":"46","author":"Mellhammar","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1186\/cc14726","article-title":"Hemodynamic Coherence and the Rationale for Monitoring the Microcirculation","volume":"19","author":"Ince","year":"2015","journal-title":"Crit. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/MCC.0000000000000217","article-title":"Microcirculatory Disorders during Septic Shock","volume":"21","author":"Bourcier","year":"2015","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13613-019-0511-1","article-title":"Narrative Review: Clinical Assessment of Peripheral Tissue Perfusion in Septic Shock","volume":"9","author":"Hariri","year":"2019","journal-title":"Ann. Intensive Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/CCM.0b013e31819869db","article-title":"The Prognostic Value of the Subjective Assessment of Peripheral Perfusion in Critically Ill Patients","volume":"37","author":"Lima","year":"2009","journal-title":"Crit. Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13613-017-0253-x","article-title":"A Hypoperfusion Context May Aid to Interpret Hyperlactatemia in Sepsis-3 Septic Shock Patients: A Proof-of-Concept Study","volume":"7","author":"Vera","year":"2017","journal-title":"Ann. Intensive Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13613-016-0164-2","article-title":"Toe-to-Room Temperature Gradient Correlates with Tissue Perfusion and Predicts Outcome in Selected Critically Ill Patients with Severe Infections","volume":"6","author":"Bourcier","year":"2016","journal-title":"Ann. Intensive Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.jcrc.2020.08.022","article-title":"Core-to-Skin Temperature Gradient Measured by Thermography Predicts Day-8 Mortality in Septic Shock: A Prospective Observational Study","volume":"60","author":"Amson","year":"2020","journal-title":"J. Crit. Care"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ferraris, A., Bouisse, C., Mottard, N., Thiolli\u00e8re, F., Anselin, S., Piriou, V., and Allaouchiche, B. (2018). Mottling Score and Skin Temperature in Septic Shock: Relation and Impact on Prognosis in ICU. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202329"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1007\/s00134-011-2163-y","article-title":"Mottling Score Predicts Survival in Septic Shock","volume":"37","author":"Lemoinne","year":"2011","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/00003246-198510000-00009","article-title":"APACHE II: A Severity of Disease Classification System","volume":"13","author":"Knaus","year":"1985","journal-title":"Crit. Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/BF01709751","article-title":"The SOFA (Sepsis-Related Organ Failure Assessment) Score to Describe Organ Dysfunction\/Failure. On Behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine","volume":"22","author":"Vincent","year":"1996","journal-title":"Intensive Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1007\/s00421-014-2940-8","article-title":"Hands and Feet: Physiological Insulators, Radiators and Evaporators","volume":"114","author":"Taylor","year":"2014","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.hrtlng.2009.04.002","article-title":"Skin Temperature and Core-Peripheral Temperature Gradient as Markers of Hemodynamic Status in Critically Ill Patients: A Review","volume":"39","author":"Schey","year":"2010","journal-title":"Heart Lung"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gupta, A., Puliyel, J., Garg, B., and Upadhyay, P. (2020). Mean Core to Peripheral Temperature Difference and Mean Lactate Levels in First 6 Hours of Hospitalisation as Two Indicators of Prognosis: An Observational Cohort Study. BMC Pediatr., 20.","DOI":"10.1186\/s12887-020-02418-w"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"R33","DOI":"10.1088\/0967-3334\/33\/3\/R33","article-title":"Infrared Thermal Imaging in Medicine","volume":"33","author":"Ring","year":"2012","journal-title":"Physiol. Meas."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1088\/0967-3334\/29\/4\/007","article-title":"Reproducibility of Infrared Thermography Measurements in Healthy Individuals","volume":"29","author":"Zaproudina","year":"2008","journal-title":"Physiol. Meas."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/j.1749-6632.1999.tb07964.x","article-title":"Study on the Distribution Pattern of Skin Temperature in Normal Chinese and Detection of the Depth of Early Burn Wound by Infrared Thermography","volume":"888","author":"Zhu","year":"1999","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/00000542-199009000-00027","article-title":"Skin-Surface Temperature Gradients Correlate with Fingertip Blood Flow in Humans","volume":"73","author":"Rubinstein","year":"1990","journal-title":"Anesthesiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jtherbio.2014.10.006","article-title":"Considerations for the Measurement of Core, Skin and Mean Body Temperatures","volume":"46","author":"Taylor","year":"2014","journal-title":"J. Therm. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/2110-5820-3-31","article-title":"Alteration of Skin Perfusion in Mottling Area during Septic Shock","volume":"3","author":"Bourcier","year":"2013","journal-title":"Ann. Intensive Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1161\/01.CIR.39.1.131","article-title":"Temperature of the Great Toe as an Indication of the Severity of Shock","volume":"39","author":"Joly","year":"1969","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jcrc.2011.05.024","article-title":"Evolution of Peripheral vs Metabolic Perfusion Parameters during Septic Shock Resuscitation. A Clinical-Physiologic Study","volume":"27","author":"Hernandez","year":"2012","journal-title":"J. Crit. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/BF00254125","article-title":"Toe Temperature versus Transcutaneous Oxygen Tension Monitoring during Acute Circulatory Failure","volume":"14","author":"Vincent","year":"1988","journal-title":"Intensive Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/joa.13004","article-title":"Vascular Coverage of the Anterior Knee Region\u2014An Anatomical Study","volume":"235","author":"Hirtler","year":"2019","journal-title":"J. Anat."},{"key":"ref_27","first-page":"e11304","article-title":"\u201cCool Knees\u201d as a Measure of Systemic Vascular Resistance in Cardiac Patients","volume":"12","author":"Westcott","year":"2020","journal-title":"Cureus"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1053\/j.jvca.2021.05.018","article-title":"Core-Peripheral Temperature Gradient and Skin Temperature as Predictors of Major Adverse Events Among Postoperative Pediatric Cardiac Patients","volume":"36","author":"Kimura","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"104309","DOI":"10.1016\/j.compbiomed.2021.104309","article-title":"A Method to Produce High Contrast Vein Visualization in Active Dynamic Thermography (ADT)","volume":"132","author":"Saxena","year":"2021","journal-title":"Comput. Biol. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103718","DOI":"10.1016\/j.compbiomed.2020.103718","article-title":"Active Dynamic Thermography to Detect the Presence of Stenosis in the Carotid Artery","volume":"120","author":"Saxena","year":"2020","journal-title":"Comput. Biol. Med."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/10\/6\/729\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:55:45Z","timestamp":1760126145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/10\/6\/729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,18]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["bioengineering10060729"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering10060729","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,18]]}}}