Table 1 Summary of selected studies investigating clinical parameters of peripheral tissue in critically ill sepsis patients
From: Narrative review: clinical assessment of peripheral tissue perfusion in septic shock
Parameters | References | Patients’ number | % sepsis | % septic shock | Relation to organ failure severity | Relation to mortality | Changes following resuscitation |
|---|---|---|---|---|---|---|---|
Peripheral temperature | |||||||
Subjective assessment: cold versus warm extremities | Kaplan et al. [20] | 264 | 42 | – | Cold extremities group had lower cardiac index, lower SvO2 and higher lactate levels | – | – |
Toe-to-room temperature gradient | Joly et al. [22] | 100 | 20 | Temperature gradient lower in non-survivors | Temperature gradient increased in non-survivors following resuscitation but decreased in non-survivors | ||
Toe-to-room temperature gradient | Bourcier et al. [28] | 103 | 39 | 61 | – | Lower in MOF death patients | Decreased in MOF death patients but increased in survivors |
Capillary refill time (CRT) | |||||||
Finger-tip and knee CRT | Ait-Oufella et al. [35] | 59 | 0 | 100 | Correlated with SOFA score | Related to Day-14 mortality | CRT decreased during resuscitation which is associated with better outcome |
Finger-tip CRT | Lara et al. [47] | 95 | 100 | – | – | – | Prolonged CRT following resuscitation is associated with higher organ failure severity and higher mortality |
Finger-tip CRT | Hernandez et al. [46] | 104 | 0 | 100 | – | – | CRT is normalized within 6 h following resuscitation, whereas lactate normalization is longer |
Mottling | |||||||
Mottling score after initial resuscitation | Ait-Oufella et al. [37] | 60 | 0 | 100 | Correlated with lactate, urinary output and SOFA score | Related to Day-14 mortality | Mottling score decreased following resuscitation which was associated with better outcome |
De Moura et al. [39] | 97 | 0 | 100 | – | Related to Day-28 mortality | – | |
Preda et al. [41] | 109 | 100 | 0 | – | Related to Day-28 mortality | – | |
Mottling presence | Coudroy et al. [40] | 791 | – | – | – | Related to Day-28 mortality | Mottling persistence > 6 h was associated with higher mortality |
Combined parameters | |||||||
Finger tip CRT + temperature gradient + peripheral perfusion index | Lima et al. [21] | 50 | – | 42 | Associated with lactate levels | – | Peripheral hypoperfusion associated with worsening SOFA score following resuscitation |
CRT and central-to-toe temperature gradient | Hernandez et al. [27] | 41 | 33 | 67 | – | – | CRT is the first be normalized during resuscitation within 2 h |