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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
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.
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Date
2025-03-02
Type
Article
Subject
Body temperature, Burns, Critical care, Body temperature regulation, Resuscitation
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.
Journal / Source Title
European Burn Journal
DOI
10.3390/ebj6010011
PMID
40137007
Publisher
MDPI
Publisher’s URL
https://www.mdpi.com/journal/ebj
Publisher’s statement
Note / Copyright