Henning R J, Wiener F, Valdes S, Weil M H
Surg Gynecol Obstet. 1979 Jul;149(1):1-7.
The temperature gradient between the ventral surface of the first toe and the ambient temperature was measured and compared with established hemodynamic measurements in 71 critically ill patients. Thirty-two patients had acute myocardial infarctions, 21 patients had primary bacteremia and 18 patients had primary hypovolemia which followed acute blood loss. The temperature gradient served as a more predictable indicator of survival or fatality than either arterial pressure or cardiac index in each group of patients. Patients who improved after treatment and survived had increases in the toe minus ambient temperature gradient to more than 4 degrees C., whereas a gradient of less than 3 degrees over an interval of 12 hours was typically observed in patients who subsequently died. These observations indicate that the toe minus ambient temperature gradient provides a valuable, inexpensive and noninvasive monitor of tissue perfusion in critically ill patients.
测量了71例危重症患者的第一趾腹面与环境温度之间的温度梯度，并将其与已确立的血流动力学测量结果进行比较。32例患者患有急性心肌梗死，21例患者患有原发性菌血症，18例患者因急性失血导致原发性血容量不足。在每组患者中，温度梯度比动脉压或心脏指数更能预测生存或死亡。治疗后病情改善并存活的患者，其趾温减去环境温度的梯度增加到4摄氏度以上，而随后死亡的患者在12小时内通常观察到梯度小于3摄氏度。这些观察结果表明，趾温减去环境温度的梯度为危重症患者的组织灌注提供了一种有价值、廉价且无创的监测指标。
