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Mottling score and skin temperature in septic shock: Relation and impact on prognosis in ICU

Arnaud Ferraris1, Camille Bouisse1, Nicolas Mottard1

  • 1Service d'Anesthésie-Réanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Plos One
|August 17, 2018
PubMed
Abstract

Insights

Infrared thermography shows lower skin temperature in septic shock patients with mottling, indicating microcirculation changes. However, neither mottling score nor skin temperature reliably predicted 28-day mortality in the ICU.

Area of Science:

  • Critical Care Medicine
  • Medical Imaging
  • Sepsis Research

Background:

  • Mottling score assesses tissue perfusion in septic shock but is subjective.
  • Infrared thermography offers an objective method to evaluate skin temperature.
  • Microcirculation assessment is crucial for managing septic shock.

Purpose of the Study:

  • To compare mottling score with infrared thermography-measured skin temperature in septic shock patients.
  • To evaluate the correlation of these measures with 28-day mortality.
  • To assess the objectivity and data collection capabilities of infrared thermography.

Main Methods:

  • Prospective, observational study in an ICU.
  • Inclusion of 46 septic shock patients requiring vasoactive drugs.
  • Measurement of mottling score and skin temperature (infrared thermography) at H0 and H6.

Main Results:

  • Patients with mottling (score≥1) had significantly lower knee skin temperature at H6 (30.7 vs 33.2°C, p=0.01).
  • No significant difference in skin temperature was observed between mottling groups 1-5.
  • Neither mottling score nor skin temperature predicted 28-day mortality.

Conclusions:

  • Infrared thermography detects lower skin temperature associated with mottling, indicating microcirculation alterations.
  • Thermography provides an objective alternative to the subjective mottling score for data collection.
  • This study found that neither method reliably predicted mortality in ICU patients.

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