A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting

Abstract

Review Question/Objectives The objective of this review is to critically appraise, synthesise and present the best available evidence on extremity skin temperature as a noninvasive marker of hypoperfusion in critically ill adult patients. More specifically, the objective is to determine: The accuracy and reliability of extremity skin temperature as a marker of hypoperfusion in critically ill adults. The review aims to answer the following questions: How accurate and reliable is extremity skin temperature as a noninvasive marker of hypoperfusion in critically ill adults? In this review, extremity skin temperature will be defined as the surface temperature at the feet, lower legs, hands or forearms. Hypoperfusion will be defined as the decrease in blood flow through an organ or tissue, as may occur duringlow-flow perfusion states commensurate with hypovolaemic shock. Inclusion Criteria: Types of participants: This review will consider studies that include male and female critically ill adult patients (defined as age 18 and above) admitted to the intensive care setting. Patients with either a medical or surgical diagnosis will be included. However, this review will exclude patients with pre-existing medical history of peripheral vascular disease (PVD), diabetes mellitus (DM), ischemic heart disease (IHD) and stroke. Types of interventions: The review will consider studies that evaluate the role of extremity skin temperature monitoring in the diagnosis of hypoperfusion. Skin temperature monitored subjectively via touch or palpation and objectively via skin temperature monitoring devices will both be analysed in this review for its potential to be a marker for hypoperfusion. Types of outcome measures: This review will consider studies that include the following outcome measures: The relationship between extremity skin temperature and pathological events such as sepsis, organ failure, mortality and adverse events. The relationship between extremity skin temperature measurements and conventional markers of perfusion.