Predictive value of temperature gradient from center to periphery and capillary refilling time on tissue perfusion in patients during operation
Objective To explore the predictive value of temperature gradient from center to periphery(Tc-toe)and capillary refilling time(CRT)on tissue perfusion in patients during operation.Methods A retrospective case-control study method was used to select 148 patients admitted to Surgical Intensive Care Unit of Tongren Hospital,Shanghai Jiao Tong University School of Medicine from April to July 2023.They were divided into the control group(91 cases,lactic acid level＜2.0 mmol/L)and the case group(57 cases,lactic acid level ≥ 2.0 mmol/L)based on whether their lactic acid levels were abnormal.Relevant indicators of the two groups were compared.Lactic acid as the dependent variable,multivariate logistic regression analysis was performed on the factors with P＜0.2 from univariate analysis results.Receiver operator characteristic(ROC)curve was used to evaluate the predictive value of intraoperative tissue perfusion in patients.Results There were statistically significant differences in surgical time,intraoperative blood loss,Tc-toe,CRT,consciousness and emergency surgery between the two groups(P＜0.05).Univariate logistic regression analysis showed that Tc-toe,CRT,age,consciousness,intraoperative blood loss,and emergency surgery were related to lactate levels(P＜0.05).Multivariate logistic regression analysis showed that Tc-toe(OR=5.97,95％CI:1.55-23.04,P＜0.05),CRT(OR=38.48,95％CI:7.68-192.78,P＜0.05),creatinine(OR=0.07,95％CI:0.01-0.79,P＜0.05),and coronary heart disease/arrhythmia(OR=0.15,95％CI:0.03-0.83,P＜0.05)were independent influencing factors for intraoperative tissue perfusion in patients.ROC curve analysis showed that area under the curve for Tc-toe prediction of tissue perfusion was 0.876,the cut-off value of Tc-toe was 1.05 ℃,the sensitivity of Tc-toe was 80.22％,and the specificity of Tc-toe was 87.72％;area under the curve for CRT prediction of tissue perfusion was 0.919,the cut-off value of CRT was 2.5 s,the sensitivity of CRT was 74.73％,and the specificity of CRT was 96.49％.Conclusion Tc-toe and CRT can predict intraoperative tissue perfusion in patients by predicting blood lactate levels.
Temperature gradientCapillary refilling timeTissue perfusion
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