Mottling score and skin temperature in septic shock: Relation and impact on prognosis in ICU
Open accessAbstract
INTRODUCTION: Mottling score, defined by 5 areas over the knee is developed to evaluate tissue perfusion at bedside. Because of the subjective aspect of the score, we aimed to compare mottling score and skin temperature in septic shock with infrared thermography in ICU and the correlation to survival. METHODS: We conducted a prospective and observational study in a teaching hospital in France during 8 months in ICU. All patients with sepsis requiring vasoactive drugs were included. We recorded epidemiologic data, hemodynamic parameters, mottling score and skin temperature with a thermic camera of the 5 mottling areas around the knee (temperatures recorded with FLIR™ software) at bedside. Measures were performed at ICU admission (H0) and six hours after initial resuscitation (H6). RESULTS: 46 patients were included. Median age was 69 (60-78), SOFA score 11 (8-12) mean SAPS II was 57±20 and 28-day mortality rate was 30%. Patients with mottling (score≥1), had a skin temperature of the knee significantly lower (30.7 vs 33,2°C p = 0.01 at H6) than patients without mottling (score = 0). Skin temperatures of the knee in mottling groups 1 to 5 were similar at H0 and H6. Neither mottling score nor skin temperature of the knee were associated with prognostic regarding day-28 mortality. CONCLUSIONS: Skin temperature measured with infrared thermography technology around the knee is lower when mottling sign is present and sign microcirculation alterations. This method, compared to standard mottling score is objective and allows data collections. However, this method failed to predict mortality in ICU patients.
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Infrared thermography offers objective and reproducible measurements, making it suitable for evaluating peripheral perfusion and microcirculation.
“IRT, a noninvasive imaging modality, offers objective and reproducible measurements, which makes it suitable for evaluating peripheral perfusion and microcirculation [26].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [26]
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- Authors
- Ferraris, A., Bouisse, C., Mottard, N., Thiollière, F., Anselin, S., Piriou, V., & Allaouchiche, B.
- Affiliations
- Hospices Civils de Lyon (FR)
- Lyon 1 Université (FR)
- Corresponding author
- Ferraris, Arnaud
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-08-16
- Volume
- 13
- Issue
- 8
- Pages
- e0202329
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6095547
- OpenAlex
- W2887132055
- Cited by
- 45
- References
- 23
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 1 · 2021: 5 · 2020: 10
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Infrared Thermography in Medicine
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- skin temperature, septic shock, infrared thermography, tissue perfusion, microcirculation, 28-day mortality, prognosis, vasoactive drugs, sepsis, intensive care unit
- MeSH terms
- Aged, Critical Care, Female, Hospitals, Teaching, Humans, Intensive Care Units, Knee, Length of Stay, Male, Microcirculation, Middle Aged, Prognosis, Severity of Illness Index, Shock, Septic, Skin Temperature, Thermography
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