A Prospective, Single-center Study of Temperature Gradients for Sepsis Severity and Fluid Resuscitation

Sepsis remains a great challenge for clinicians. Early and timely fluid resuscitation is the basic measure for the treatment of sepsis. It is important to quickly diagnose the severity of sepsis and evaluate the effects of fluid resuscitation. Existing monitoring methods such as blood pressure, urine volume, blood lactate, central venous oxygen saturation (ScvO2), cardiac output (CO), stroke volume variability (SVV), etc. have certain limitations or invasive disadvantages. Clinically, effective and convenient non-invasive means are needed for monitoring. Present research revealed that microcirculatory dysfunction and tissue hypoperfusion have a very important role in the pathophysiological mechanism of sepsis, and will be associated with severe organ dysfunction, which is closely related to serious adverse prognosis. Importantly, tissue hypoperfusion can cause central and peripheral body temperature changes. Studies have shown that clinical assessment of peripheral skin temperature can identify potential severe organ dysfunction in patients with stable hemodynamics. The latest study found that patients with septic shock have greater central-peripheral body temperature differences than sepsis patients, and the temperature difference between peripheral-room temperature is smaller. That is, the central-peripheral-room temperature gradient changes show a reduction of tissue perfusion, suggesting microcirculatory disorders and organ dysfunction. In addition, the body temperature gradient is simple and non-invasive, and is a bedside indicator that predicts tissue perfusion.