The significance of peripheral skill temperature measurement during the acute phase of burn injury: an illustrative case report

An increase in the gradient between core and peripheral skill temperature i s a common finding during the early post burn period which is often interpr eted as an indication of inadequate circulating blood volume. In this case study we monitored the pattern of rectal and skin surface (toe) temperature and skin blood flow (by laser Doppler imaging) during the first 16 h after a 34% bath scald in a child (female) of 36 months. In the absence of invas ive monitoring of cardiac output, clinical assessment of the adequacy of fl uid resuscitation was made from changes in hourly urine volumes and regular (4-h) monitoring of haematocrit. Peripheral vasoconstriction, leading to a n increase in the temperature gradient between the inside and outside of th e body, was not related to either a fall in urine volume or to haemoconcent ration. We suggest that during the first 16 h after burn injury, widening o f the core-to-peripheral temperature gradient cannot be used reliably as a clinical indicator of inadequate circulating blood volume. (C) 2000 Elsevie r Science Ltd and ISBI. All rights reserved.