ArticleAnnals of intensive care2018
Skin microcirculatory reactivity assessed using a thermal challenge is decreased in patients with circulatory shock and associated with outcome.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 29 citations in OpenAlex.
- Infrared Thermographic Evaluation Following Hemilaminectomy in Dogs with Thoracolumbar Intervertebral Disc Extrusion: A Pilot Study.Animals : an open access journal from MDPI · 2026Article
- Thermal intervention improves pulse oximetry accuracy in critically ill patients with low perfusion: a quasi-experimental study.Journal of intensive care · 2026Article
- Early detection of microcirculatory changes using simultaneous heated and unheated transcutaneous blood gas monitoring: a proof-of-concept study in a porcine lipopolysaccharide model of systemic inflammation.Frontiers in medicine · 2026Article
- Characterization of microvessels in the human forehead dermis using intravascular dual perfusion and immunofluorescence staining.Scientific reports · 2025Article
- Skin injury: Associations with variables related to perfusion and pressure.Anaesthesia and intensive care · 2024Article
- Intradermal Treatment with a Hyaluronic Acid Complex Supplemented with Amino Acids and Antioxidant Vitamins Improves Cutaneous Hydration and Viscoelasticity in Healthy Subjects.Antioxidants (Basel, Switzerland) · 2024Article
- Exploring the relationship between capillary refill time, skin blood flow and microcirculatory reactivity during early resuscitation of patients with septic shock: a pilot study.Journal of clinical monitoring and computing · 2023Article
- New Hemodynamic Parameters in Peri-Operative and Critical Care-Challenges in Translation.Sensors (Basel, Switzerland) · 2023Review
- Transfusion increased skin blood flow when initially low in volume-resuscitated patients without acute bleeding.Frontiers in medicine · 2023Article
- Laser speckle contrast imaging to monitor microcirculation: An effective method to predict outcome in patients with sepsis and septic shock.Frontiers in bioengineering and biotechnology · 2022Article
- Monitoring skin blood flow to rapidly identify alterations in tissue perfusion during fluid removal using continuous veno-venous hemofiltration in patients with circulatory shock.Annals of intensive care · 2021Article
- Systemic microvascular endothelial dysfunction and disease severity in COVID-19 patients: Evaluation by laser Doppler perfusion monitoring and cytokine/chemokine analysis.Microvascular research · 2021Article
- Microcirculation and mean arterial pressure: friends or foes?Annals of translational medicine · 2020Article
- Transcutaneous PCOJournal of thoracic disease · 2019Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShock states are characterized by impaired tissue perfusion and microcirculatory alterations, which are directly related to outcome. Skin perfusion can be noninvasively evaluated using skin laser Doppler (SLD), which, when coupled with a local thermal challenge, may provide a measure of microcirculatory reactivity. We hypothesized that this microvascular reactivity would be impaired in patients with circulatory shock and would be a marker of severity.
methodsWe first evaluated skin blood flow (SBF) using SLD on the forearm and on the palm in 18 healthy volunteers to select the site with maximal response. Measurements were taken at 37 °C (baseline) and repeated at 43 °C. The 43 °C/37 °C SBF ratio was calculated as a measure of microvascular reactivity. We then evaluated the SBF in 29 patients with circulatory shock admitted to a 35-bed department of intensive care and in a confirmatory cohort of 35 patients with circulatory shock.
resultsIn the volunteers, baseline SBF was higher in the hand than in the forearm, but the SBF ratio was lower (11.2 [9.4-13.4] vs. 2.0 [1.7-2.6], p < 0.01) so we used the forearm for our patients. Baseline forearm SBF was similar in patients with shock and healthy volunteers, but the SBF ratio was markedly lower in the patients (2.6 [2.0-3.6] vs. 11.2 [9.4-13.4], p < 0.01). Shock survivors had a higher SBF ratio than non-survivors (3.2 [2.2-6.2] vs. 2.3 [1.7-2.8], p < 0.01). These results were confirmed in the second cohort of 35 patients. In multivariable analysis, the APACHE II score and the SBF ratio were independently associated with mortality.
conclusionsMicrocirculatory reactivity is decreased in patients with circulatory shock and has prognostic value. This simple, noninvasive test could help in monitoring the peripheral microcirculation in acutely ill patients.
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