Peripheral Perfusion Index
Conditions
Brief summary
Many patients undergoing long time surgery will manifest increased level of blood lactate. Hyperlactacidemia can cause disturbance of internal environment, then leading to increased complications and longer ICU stay, even death. For postoperative patients, we must ensure adequate perfusion in order to minimize the length of hyperglycemia and improve patients' outcomes. With regard to lactate, it provides information about prefusion, but not timely enough for its delay on reflecting hypoperfusion. And it's not real-time and non-invasive. Peripheral perfusion index (PPI) is an indicator reflecting hypoperfusion in critical patients. It is measured using pulse co-oximetry technology which is characterized by being real-time and noninvasive. PPI is defined as the ratio of pulsatile blood flow to the non-pulsatile blood flow, mirroring the strength of blood flow and quality of perfusion at sensor site, reflecting perfusion state of the body part . In contrast to lactate value, it's real-time and easy to monitor.
Interventions
DIAGNOSTIC_TESTPeripheral Perfusion index
Peripheral Perfusion index is the ratio between pulsatile blood flow to non pulsatile blood flow or static blood in the peripheral tissue
DIAGNOSTIC_TESTserum lactate level
Blood lactate (product of metabolism) level is maintained by a cycle of continuous production and metabolism allowing it to be kept within normal values
Sponsors
Cairo University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Inclusion criteria * Adult patients above 18 years of age. * Both genders * surgical time planned to be \> 120 minutes . * surgical time predicted to exceed the planned time and prolongation of surgical time \> 120 minutes occured will be included in the study . * ASA physical status of I-II * Patients scheduled for elective surgery under general anaesthesia . *
Exclusion criteria
* Refused to participate . * patient with disease affecting blood flow to the hands where probe will be applied . * patient with hand injuries so probe cannot be applied * Patient with sever renal and liver disease * Discharging against medical advice or reported death during ICU stay at first 48 hours after ICU admission . * Pregnancy or emergency surgery . * shortening of the planned surgical time to be less than 120 minutes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peripheral perfusion index | up to 48 hours | at end of surgery as early predictor of postoperative complications . |
| serum lactate level | up do 48 hours | at end of surgery as early predictor of postoperative complications . |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative complications | up to 30 day | the Clavien-Dindo classification system Grade I complications Grade II complications Grade III complications Grade IV complications |
| serum lactate level | UP TO 30 day | at end of surgery as early predictor of postoperative complications . |
| heart rate | up do 48 hours | hemodynamic change |
| hemodynamic change | up do 48 hours | mean arterial blood pressure |
| Peripheral perfusion index | UP TO 30 DAY | at end of surgery as predictor seversity of postoperative complications . |
Countries
Egypt
Outcome results
None listed