Peripheral Perfusion
Conditions
Keywords
capillary refill time, vascular occlusion test, device, impaired perfusion, healthy volunteers.
Brief summary
To estimate peripheral perfusion in shock state, international guidelines recommend the use of capillary refill time, and practitioners currently evaluates it at bedside. However its measurement is not standardized, what should explain the large observer variability reported in different studies. Hence, a device providing a standardized evaluation seems to be helpful. The aim of the study is to evaluate diagnostic performance of such a device recently developped (DiCART TM), in healthy volunteers experiencing vascular occlusion tests to induce impaired perfusion.
Interventions
DEVICEmeasure capillary refill time
Each time, capillary refill time will be evaluated three times consecutively by clinical method applying a firm pressure with the finger during 15s, then brutally releasing it, and estimating time of skin recoloration with a chronometer and by DiCART TM device Three vascular occlusion tests will be successively performed with a cuff during less than 10 minutes: * Arterial vascular occlusion test (50mmHg above systolic arterial pressure of the healthy volunteers), * Veinous vascular occlusion test (30mmHg), * Control test without vascular occlusion test. Capillary refill time measurements will be repeated just before, during and just after vascular occlusion tests. Randomization determine the order of the vascular occlusion tests. Investigators performing capillary refill time evaluation will be blinded from it. Vascular occlusion tests will be alternatively performed by one and the other limb. The whole protocol will be performed at the upper and then at the lower limb.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Masking description
the investigators evaluate capillary refill time without knowing the status of vascular occlusion test.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Healthy volunteers * Age \> 18 years old * Informed consent to participate
Exclusion criteria
* Vascular disease * Diabetes mellitus * Dermatosis * Cutaneous lesion on a measurement site * Anemia * Pregnancy * Cardiovascular chronic treatment * Non affiliation to a social security regime * Involvement in other interventional study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Capillary refill time on the thenar eminence evaluated with DiCART TM device. | 180 minutes | Diagnostic performance of DiCART TM device to detect a capillary refill time variation on the thenar eminence induced by a vascular occlusion test on the arm. DiCART TM measurement is fully automatized, and may be separated in three consecutive step : * An automatized cutaneous compression * A video acquisition of cutaneous recoloration * Data interpretation The investigators will compute Receptor Operative Characteristics curves with area under the curve, and will determine best threshold and grey zone to evaluate diagnostic performance of DiCART TM device to detect impaired perfusion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Capillary refill time variation induced by vascular occlusion test on the knee with standard clinical method | 180 minutes | Standard clinical measurement is realized by applying a firm pressure with the finger during 15s and by brutally releasing it. Then, skin recoloration is evaluated visually with a chronometer. |
| Capillary refill time variation induced by vascular occlusion test on the thenar eminence with DiCART TM device . | 180 minutes | Standard clinical measurement is realized by applying a firm pressure with the finger during 15s and by brutally releasing it. Then, skin recoloration is evaluated visually with a chronometer. |
| Capillary refill time variation induced by vascular occlusion test on the thenar eminence with standard clinical method. | 180 minutes | Standard clinical measurement is realized by applying a firm pressure with the finger during 15s and by brutally releasing it. Then, skin recoloration is evaluated visually with a chronometer. |
| Capillary refill time measured by mathematical algorithms | 180 minutes | After the experimental phase, the investigators will develop mathematical algorithms to optimize video data interpretation. |
| Capillary refill time evaluated on the knee with DiCART TM device | 180 minutes | Diagnostic performance of DiCART TM device to detect a capillary refill time variation on the knee induced by a vascular occlusion test on the leg DiCART TM measurement is fully automatized, and may be separated in three consecutive step : * An automatized cutaneous compression * A video acquisition of cutaneous recoloration * Data interpretation The investigators will compute Receptor Operative Characteristics curves with area under the curve, and will determine best threshold and grey zone to evaluate diagnostic performance of DiCART TM device to detect impaired perfusion. |
| Pain evaluation assessed by numeric rating scale | 180 minutes | Pain scale (minimum 1 to maximum 10), 1=No pain,10=Unbearable pain |
| Intra -observer variability of capillary refill time measurement with clinical method by performing repetitive measurements by two different investigators. | 180 minutes | Two different investigators will realize 5 measurements of capillary refill time with DiCART TM device and standard clinical method in physiological conditions in two different sites (knee and thenar eminence). We will compute least significant change and standard deviation/mean ratio to evaluate observer variability. |
| Inter-observer variability of capillary refill time measurement with DiCART TM device by performing repetitive measurements by two different investigators. | 180 minutes | Two different investigators will realize 5 measurements of capillary refill time with DiCART TM device and standard clinical method in physiological conditions in two different sites (knee and thenar eminence). We will compute least significant change and standard deviation/mean ratio to evaluate observer variability. |
| Inter-observer variability of capillary refill time measurement with clinical method by performing repetitive measurements by two different investigators. | 180 minutes | Two different investigators will realize 5 measurements of capillary refill time with DiCART TM device and standard clinical method in physiological conditions in two different sites (knee and thenar eminence). We will compute least significant change and standard deviation/mean ratio to evaluate observer variability. |
| Capillary refill time variation induced by vascular occlusion test on the knee with DiCART TM device | 180 minutes | Standard clinical measurement is realized by applying a firm pressure with the finger during 15s and by brutally releasing it. Then, skin recoloration is evaluated visually with a chronometer. |
| number of patients with cutaneous lesions | 180 minutes | To evaluate the safety of DiCART TM device |
| Intra -observer variability of capillary refill time measurement with DiCART TM device by performing repetitive measurements by two different investigators. | 180 minutes | Two different investigators will realize 5 measurements of capillary refill time with DiCART TM device and standard clinical method in physiological conditions in two different sites (knee and thenar eminence). We will compute least significant change and standard deviation/mean ratio to evaluate observer variability. |
Countries
France
Outcome results
None listed