Performance of Early Capillary Refill Time Measurement on Outcomes in Cardiogenic Shock: An Observational, Prospective Multicentric Study

毛细管再灌注 医学 心源性休克 观察研究 心脏病学 休克(循环) 内科学 前瞻性队列研究 血压 心肌梗塞 重症监护医学
作者
Hamid Merdji,Anaïs Curtiaud,Antoine Aheto,Antoine Studer,Veli‐Pekka Harjola,Alexandra Monnier,Kévin Duarte,Nicolas Girerd,Marion Kibler,Hafid Ait‐Oufella,Julie Helms,Alexandre Mebazaa,Bruno Lévy,Antoine Kimmoun,Ferhat Meziani
出处
期刊:American Journal of Respiratory and Critical Care Medicine [American Thoracic Society]
卷期号:206 (10): 1230-1238 被引量:24
标识
DOI:10.1164/rccm.202204-0687oc
摘要

Rationale: Identification of cardiogenic shock severity is a critical step to adapt the management level upon admission. Peripheral tissue perfusion signs, simple and reliable markers of tissue hypoperfusion have never been extensively assessed during cardiogenic shock. Objectives: To assess the correlation of capillary refill time values with 90-day mortality in cardiogenic shock patients or the need for venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Also to assess the correlation between capillary refill time and hemodynamic parameters. Methods: All consecutive patients with cardiogenic shock admitted to the intensive care unit of two tertiary teaching hospitals were included in a prospective observational study. Macro-hemodynamic parameters (such as heart rate, blood pressure, left ventricular ejection fraction, and cardiac index) and peripheral tissue perfusion signs, such as capillary refill time on the index fingertip, mottling, and Pv-aCO2 (the difference between partial pressure of CO2 between venous and arterial blood) were recorded at inclusion (0 hour), 6 hours, 12 hours, 24 hours, and 48 hours. The composite primary endpoint was the association between 90-day mortality or the need for VA-ECMO support. Measurements and Main Results: A total of 61 patients were included; at inclusion, simplified acute physiology score II was 64 (52-77) points. The primary endpoint was met by 42% of patients. Capillary refill time values were significantly higher at all time points in nonsurvivors or patients needing VA-ECMO support. In univariate analysis, capillary refill time > 3 seconds at inclusion was associated with 90-day all-cause mortality or VA-ECMO support (hazard ratio, 12.38; 95% confidence interval, 2.91-52.71). Capillary refill time at inclusion was poorly associated with macrocirculatory parameters but significantly correlated with microcirculatory parameters. Further, capillary refill time added incremental value to Cardshock score, with an AUC combination at 0.93. Conclusions: In patients with cardiogenic shock admitted to the ICU, our preliminary data suggest that a prolonged capillary refill time >3 seconds was associated with an early prediction of 90-day mortality or the need for VA-ECMO support.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
机灵枕头完成签到 ,获得积分10
1秒前
糖糖科研顺利呀完成签到 ,获得积分10
3秒前
辣小扬完成签到 ,获得积分10
5秒前
传奇3应助水晶茶杯采纳,获得10
7秒前
幽默的素阴完成签到 ,获得积分10
11秒前
小小鱼完成签到 ,获得积分10
18秒前
18秒前
甜美砖家完成签到 ,获得积分10
20秒前
superspace完成签到,获得积分10
21秒前
nn发布了新的文献求助10
23秒前
求助完成签到,获得积分10
24秒前
25秒前
翁雁丝完成签到 ,获得积分10
32秒前
郭义敏完成签到,获得积分0
32秒前
gyf完成签到,获得积分10
35秒前
李保龙完成签到 ,获得积分10
36秒前
40秒前
LJJ完成签到 ,获得积分10
41秒前
量子星尘发布了新的文献求助10
44秒前
阿姨洗铁路完成签到 ,获得积分10
49秒前
抹不掉的记忆完成签到,获得积分10
51秒前
51秒前
余杭村王小虎完成签到,获得积分10
52秒前
韭黄完成签到,获得积分20
56秒前
jeffrey完成签到,获得积分10
56秒前
Rondab应助机灵枕头采纳,获得10
1分钟前
佳无夜完成签到,获得积分10
1分钟前
摆哥完成签到,获得积分10
1分钟前
66完成签到,获得积分10
1分钟前
zlqq完成签到 ,获得积分10
1分钟前
Hardskills发布了新的文献求助10
1分钟前
1分钟前
之_ZH完成签到 ,获得积分10
1分钟前
gds2021完成签到 ,获得积分10
1分钟前
你好呀嘻嘻完成签到 ,获得积分10
1分钟前
梅特卡夫完成签到,获得积分10
1分钟前
熊雅完成签到,获得积分10
1分钟前
1分钟前
睡到自然醒完成签到 ,获得积分10
1分钟前
cis2014完成签到,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038112
求助须知:如何正确求助?哪些是违规求助? 3575788
关于积分的说明 11373801
捐赠科研通 3305604
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022