Mind the Gap! Core-peripheral temperature gradient and its relationship to mortality in major burns
Keohane, Niamh Driver, Jennifer Mullhi, Randeep Chipp, Elizabeth Torlinska, Barbara Torlinski, Tomasz
Keohane, Niamh
Driver, Jennifer
Mullhi, Randeep
Chipp, Elizabeth
Torlinska, Barbara
Torlinski, Tomasz
Affiliation
Worcestershire Acute Hospitals NHS Trust; North Bristol NHS Trust; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Aston University
Other Contributors
Publication date
2025-03-02
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
The association between hypothermia and poor outcomes in severe burn injury is well established. However, the significance of the core-peripheral temperature gradient has not previously been investigated. Institutional guidance at our burns centre advocates avoiding hypothermia and targeting a body temperature between 37.5 and 39.5 °C. The core-peripheral temperature gap should be ≤2 °C, based on expert opinion. Data from 61 patients admitted to the Intensive Care Unit (ICU) with severe burns between 2016 and 2022 were analysed. A higher core temperature at 48 h, avoidance of hypothermia and a core-peripheral temperature gap > 2 °C were associated with reduced odds of mortality. The mean core body temperature and core-peripheral temperature gap increased over the first 48 h (r = 0.5, p < 0.001). All non-survivors had a core-peripheral gap < 2 °C at 48 h. Survivors had a higher mean 48 h gap (1.6 [95%CI:1.3-1.9]) than non-survivors (0.8 [95%CI:0.2-1.4; p = 0.04]). Our findings support previous studies suggesting that avoiding hypothermia and achieving a higher target temperature are associated with reduced mortality. However, it challenges the previous expert consensus that a lower core-peripheral gap indicates better outcomes. Further research with a larger cohort of patients is required to identify whether a higher core-peripheral temperature gap predicts outcomes in critically ill patients with severe burns.
Citation
Keohane N, Driver J, Mullhi R, Chipp E, Torlinska B, Torlinski T. Mind the Gap! Core-Peripheral Temperature Gradient and Its Relationship to Mortality in Major Burns. Eur Burn J. 2025 Mar 2;6(1):11. doi: 10.3390/ebj6010011.
Type
Article