Body temperature gradients in childhood shock states

ABSTRACT

This study was carried out on 30 infants and children [excluding new- borns], suffering from either peripheral circulatory insufficiency states or frank shock who were admitted to the New Children Hospital of Cairo University. The study spotlighted the value of the intimate relationship between peripheral circulatory perfusion and body temperature gradients; the gradient between deep [core] and peripheral [sole/skin] temperature. The more the severity of peripheral circulatory insufficiency, the greater the temperature gradient. The study showed that temperature gradient more than 5C is suspicious of circulatory insufficiency but more than 6C is a sure sign of frank shock which also correlated well to skin temperature of the limbs towards the trunk; the more the peripheral circulatory insufficiency the cooler the skin temperature by hand palpation. Hence, estimation of temperature gradients in shock states is a simple noninvasive, rapid, bed side easily repeatable for the diagnosis and follow up of therapy of shock without the need of invasive techniques as central venous pressure or pulmonary wedge pressure. So, it is recommended to determine the temperature gradient as a routine test in critically ill children especially those prone to develop shock