Peripheral Perfusion
Conditions
Keywords
critically ill patients, septic shock, peripheral perfusion index, capillary refill time, mottling score, microcirculation
Brief summary
The purpose of this study is to evaluate PPI as a surrogate for clinical signs of peripheral perfusion in patients in septic shock and after cardiac surgery.
Detailed description
The aim of this study is to validate PPI as a continuous, objective measurement of peripheral perfusion indicated by clinical sings of tissue perfusion in patients with septic shock. Furthermore, PPI shall be compared to the perfusion of solid organs evaluated by ultrasound of liver, kidney and gut. In a group of healthy volunteers the investigators will determine normal values in ambient temperature and after cooling of an extremity. Another group of patients after cardiac surgery, where usually a poor tissue perfusion without metabolic failure is present will serve as another control population in their post-surgery stabilization period. The values from healthy volunteers and cardiac surgery patients will be compared to those of patients in septic shock.
Interventions
DEVICEPeripheral Perfusion index by Carescape Patientenmonitor
Peripheral Perfusion index measured with pulse-oximetry by Carescape Patientenmonitor
Sponsors
Insel Gruppe AG, University Hospital Bern
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Septic patient: Inclusion criteria: * ICU admission with septic shock defined as: * documented infection (suspected or confirmed) AND * systemic mean blood pressure \<65mmHg requiring any dose of vasopressor despite adequate fluid resuscitation (min. 20ml/kg crystalloids) AND * lactate \>2mmol/l * Deferred consent by a relative with following informed consent by patient as documented by signatures (Appendix Informed Consent Form)
Exclusion criteria
* Age \<18 or \>80 years * present or suspected myocardial ischemia * acute pulmonary embolism * known liver disease - Child-Pugh -Class B or C * known chronic renal failure * known peripheral artery disease Patient after cardiac surgery: Inclusion criteria: * ICU admission after coronary artery bypass grafting or valve surgery with cardiopulmonary bypass * General consent with admission at the University hospital
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| peripheral perfusion index | measurement at ICU admission and hourly till extubation or normalization of lactate, during the hospitalization without follow-up (maximal up to 72h) | PPI in healthy controls, septic shock patients and patients rewarming after cardiac surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| capillary refill time | measurement at ICU admission and hourly till extubation or normalization of lactate, during the hospitalization without follow-up (maximal up to 72h) | CRT in healthy controls, septic shock patients and patients rewarming after cardiac surgery |
Other
| Measure | Time frame | Description |
|---|---|---|
| sonographic assesment of solid organ perfusion | within 24h after ICU admission and 24h after first measurement | solid organ perfusion measured by ultrasound |
Countries
Switzerland
Outcome results
None listed