Andreas Brunauer1, Andreas Koköfer1, Otgon Bataar2, Ilse Gradwohl-Matis1, Daniel Dankl1, Jan Bakker3, Martin W Dünser4. 1. Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria. 2. Department of Emergency and Critical Care Medicine, Central State University Hospital, Ulaanbaatar, Mongolia. 3. Department of Intensive Care Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Medical Center, New York, NY; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de, Chile, Santiago. 4. Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria. Electronic address: M.Duenser@salk.at.
Abstract
PURPOSE: To correlate clinical indicators of peripheral perfusion with visceral organ vascular tone in 30 septic shock patients. MATERIALS AND METHODS: In a prospective pilot study, capillary refill time, the Mottling score, and peripheral temperature were determined within 24, 48, and 72 hours after intensive care unit admission. Simultaneously, pulsatility indices in the liver, spleen, kidneys, and intestines were measured by Doppler ultrasonography. Correlation analyses were calculated, applying an adjusted significance level (P< .0125) to correct for multiple testing. RESULTS: Significant relationships were observed between the pulsatility index of selected organs and the capillary refill time (intestines: r= 0.325, P= .007), and the Mottling score (kidneys: r= 0.396, P= .006), but not peripheral temperature (all r< 0.14, P> .05). An association over time was observed for the capillary refill time and pulsatility index of the liver (P= .04) and intestines (P= .03) as well as for the Mottling score and the kidneys' pulsatility index (P= .03), but not for peripheral temperature and any visceral organs' pulsatility index. CONCLUSIONS: Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.
PURPOSE: To correlate clinical indicators of peripheral perfusion with visceral organ vascular tone in 30 septic shockpatients. MATERIALS AND METHODS: In a prospective pilot study, capillary refill time, the Mottling score, and peripheral temperature were determined within 24, 48, and 72 hours after intensive care unit admission. Simultaneously, pulsatility indices in the liver, spleen, kidneys, and intestines were measured by Doppler ultrasonography. Correlation analyses were calculated, applying an adjusted significance level (P< .0125) to correct for multiple testing. RESULTS: Significant relationships were observed between the pulsatility index of selected organs and the capillary refill time (intestines: r= 0.325, P= .007), and the Mottling score (kidneys: r= 0.396, P= .006), but not peripheral temperature (all r< 0.14, P> .05). An association over time was observed for the capillary refill time and pulsatility index of the liver (P= .04) and intestines (P= .03) as well as for the Mottling score and the kidneys' pulsatility index (P= .03), but not for peripheral temperature and any visceral organs' pulsatility index. CONCLUSIONS: Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.
Authors: Daniel De Backer; Jan Bakker; Maurizio Cecconi; Ludhmila Hajjar; Da Wei Liu; Suzanna Lobo; Xavier Monnet; Andrea Morelli; Sheila Neinan Myatra; Azriel Perel; Michael R Pinsky; Bernd Saugel; Jean-Louis Teboul; Antoine Vieillard-Baron; Jean-Louis Vincent Journal: Intensive Care Med Date: 2018-05-03 Impact factor: 17.440
Authors: David Misango; Rajyabardhan Pattnaik; Tim Baker; Martin W Dünser; Arjen M Dondorp; Marcus J Schultz Journal: Trans R Soc Trop Med Hyg Date: 2017-11-01 Impact factor: 2.184