Abstract:
OBJECTIVES:Capillary refill time is a noninvasive method to assess tissue perfusion to determine shock status. Capillary refill time is defined as the time required to regain skin color after blanching pressure is applied. Although common methods to measure capillary refill time depend on clinicians' visual assessment, a new approach using a pulse oximeter waveform analysis exists, referred to as full finger reperfusion time. We aim to evaluate reproducibility and validity of the novel full finger reperfusion time measurement using clinicians' visual capillary refill time assessment as a reference standard. DESIGN:Prospective observational study. SETTING:PICUs and operating suites at a large academic children's hospital. PATIENTS:Ninety-nine children 1-12 years old with various skin color tones. INTERVENTIONS:Each child had 10 measurements, including five full finger reperfusion time and five clinician capillary refill time, alternating second and third digits. MEASUREMENTS AND MAIN RESULTS:Eighteen children had prolonged capillary refill time (> 2 s) and four children with capillary refill time greater than 3 seconds. Four-hundred eighty-five data pairs were analyzed. Intraclass correlation coefficient of full finger reperfusion time within each patient was 0.76 (95% CI, 0.68-0.83), demonstrating good reproducibility. Correlation coefficient between full finger reperfusion time and clinician capillary refill time was moderate: r = 0.37 (p < 0.0001; 95% CI, 0.29-0.44) for the pairs and r = 0.52 (p < 0.0001; 95% CI, 0.36-0.65) for patient average. Bland-Altman plot showed a consistent difference between full finger reperfusion time and clinician capillary refill time (full finger reperfusion time 1.14 s longer). Weak association was found between force and full finger reperfusion time (β = -0.033 ± 0.016; 95% CI, -0.065 to -0.0016; p = 0.04), finger thickness (β = -0.20 ± 0.089; 95% CI, -0.37 to -0.19; p = 0.03), except for color tone (p = 0.31). Finger temperature was associated with full finger reperfusion time (β = -0.18 ± 0.041; 95% CI, -0.26 to -0.0999; p < 0.0001). CONCLUSIONS:Full finger reperfusion time demonstrated good reproducibility. Full finger reperfusion time showed moderate correlation with clinician capillary refill time. Full finger reperfusion time was 1.14 seconds longer than capillary refill time. Future studies should focus on the clinical value of full finger reperfusion time as a monitoring device for hemodynamics in critically ill children.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Nickel AJ,Jiang S,Napolitano N,Yehya N,Fitzgerald JC,Bruins BB,Lockman JL,Nadkarni VM,Nishisaki Adoi
10.1097/CCM.0000000000004506subject
Has Abstractpub_date
2020-10-01 00:00:00pages
e927-e933issue
10eissn
0090-3493issn
1530-0293journal_volume
48pub_type
杂志文章abstract:OBJECTIVE:Several studies have suggested that intravenous hydroxyethyl starch treatment may dampen acute inflammatory responses. It is well documented that limited oxygen delivery to tissues (hypoxia) is common in acute inflammation, and numerous parallels exist between acute responses to hypoxia and to inflammation, i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000218814.77568.BC
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the prognostic value of short-latency median nerve somatosensory evoked potentials and brainstem auditory evoked potentials in outcome prediction for comatose cardiac arrest patients treated with hypothermia. DESIGN:Prospective, randomized, controlled trial of mild hypothermia after out-of-hospit...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000171536.63641.d9
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:Increasing age is a well-recognized risk factor for in-hospital mortality in patients receiving extracorporeal membrane oxygenation for cardiogenic shock, but the shape of this relationship is unknown. In addition, the impact of age on hospital length of stay, patterns of patient disposition, and costs has b...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003631
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:The epidemiology of chronic critical illness is not well known. We aimed to estimate the prevalence, mortality, and costs associated with chronic critical illness in Japan. DESIGN:A nationwide inpatient administrative database study in Japan from April 2011 to March 2018. SETTING:Six hundred seventy-nine a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004723
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVES:The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagula...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004504
更新日期:2020-10-01 00:00:00
abstract::Arterial catheterization for blood gas analysis and direct monitoring of blood pressure in infants and children can be attended by a variety of complications, which limit its use to short periods of time. An improved technique, consisting of elimination of stopcocks, the use of a continuous flushing system adapted for...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197605000-00010
更新日期:1976-05-01 00:00:00
abstract::Gastric mucosal damage produced by topical application of necrotizing agents is diminished by topical or systemic pretreatment with a variety of E and F prostaglandins. The rat restraint model of gastric mucosal injury is more analogous to clinical stress ulceration than are models using intragastric application of to...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198901000-00011
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:The role of systemic corticosteroids in pathophysiology and treatment of acute respiratory distress syndrome is controversial. Use of prehospital systemic corticosteroid therapy may prevent the development of acute respiratory distress syndrome and improve hospital outcomes. DESIGN:This is a preplanned retro...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31828a1fc7
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:Ventilator-associated pneumonia diagnosis remains a debatable topic. New definitions of ventilator-associated conditions involving worsening oxygenation have been recently proposed to make surveillance of events possibly linked to ventilator-associated pneumonia as objective as possible. The objective of the...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000000674
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN:Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regressio...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002753
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Initial success with chimeric antigen receptor-modified T cell therapy for relapsed/refractory acute lymphoblastic leukemia is leading to expanded use through multicenter trials. Cytokine release syndrome, the most severe toxicity, presents a novel critical illness syndrome with limited data regarding diagnos...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002053
更新日期:2017-02-01 00:00:00
abstract::Computerized gamma scintigraphy revealed a significant (p less than 0.001) rising lung:heart radioactivity ratio, which has been called "slope of injury" or "slope index", with both 99mTechnetium-tagged human serum albumin (99mTc-HSA) and 99mTechnetium-tagged red blood cells (99Tc-RBC) after 0.05 or 0.2 ml/kg iv oleic...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198201000-00008
更新日期:1982-01-01 00:00:00
abstract::We describe the use of continuous negative extrathoracic pressure to treat successfully the adult respiratory distress syndrome in a 19-yr-old woman who resisted the application of positive airway pressure. Arterial hypoxemia was reversed with -26 cm H2O of extrathoracic pressure, produced by a modified Emerson iron l...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVES:To describe the variety of medications prescribed along with the doses administered and routes of administration, and to delineate the clarity of orders written and the accuracy of transcription of drugs used for sedation, anxiety, pain, and neuromuscular blockade in a surgical intensive care unit (ICU). DE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199406000-00016
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:To determine whether high rates of ineffective triggering within the first 24 hrs of mechanical ventilation (MV) are associated with longer MV duration and shorter ventilator-free survival (VFS). DESIGN:Prospective cohort study. SETTING:Medical intensive care unit (ICU) at an academic medical center. PATI...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/ccm.0b013e3181a98a05
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Quality of care for patients admitted with pneumonia varies across hospitals, but causes of this variation are poorly understood. Whether hospitals with high ICU utilization for patients with pneumonia provide better quality care is unknown. We sought to investigate the relationship between a hospital's ICU a...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000925
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:Intravesical pressure measurement is considered to be the gold standard for the assessment of intra-abdominal pressure. However, this method is indirect and depends on a physiologic bladder function. We evaluated a modified piezoresistive technique and a water-capsule technique for direct and continuous intra...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000198526.04530.36
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous refe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181930174
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. DESIGN AND SETTING:A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. PATIENTS:All consecutive critically ill pat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002649
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The genetic background of hypertensive crisis is unknown. We examined the association of polymorphisms in genes involved in the renin-angiotensin-aldosterone-system with hypertensive crisis. DESIGN:Population-based case-control study. SETTING:Emergency department at a tertiary care university hospital. PAT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200210000-00010
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To determine whether aerosolized antibiotics can be delivered efficiently to the lower respiratory tract in mechanically ventilated patients and to define possible clinical responses to these agents. DESIGN:Prospective serial study with cases as their own control. SETTING:A 10-bed respiratory care unit for...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199801000-00013
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to identify which patient demographic, patient health, and hospital characteristics were associated with in-hospital mortality. A secondary objective was to determine the relative influence of these characteristics on mortality. DESIGN AND SETTING:Public-use data for ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31825bc92f
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To test the effects of three hemoglobin solutions on liver function and hepatic morphology after resuscitation from severe hemorrhagic shock. DESIGN:Prospective study. SETTING:Laboratory. SUBJECTS:Thirty-three beagle dogs. INTERVENTION:Hemorrhagic shock was induced in anesthetized dogs by removal of blood...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199604000-00019
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of mixed venous hemoglobin oxygen saturation estimated, using in vivo pulmonary artery reflectance oximetry with ranging concentrations of carboxyhemoglobin. DESIGN:Criterion standard, a comparison of an alternative test to the "gold standard." SETTING:Laboratory animal facility of a ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199407000-00022
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training prog...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003626
更新日期:2019-03-01 00:00:00
abstract::A simple, safe, and effective system for umbilical artery monitoring controls continuous fluid infusion to prevent fluid overinfusion and keep the catheter from clotting. Accurate and continuous pressure measurements can be recorded simultaneously with fluid infusion. A convenient method for checking dynamic response ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198207000-00009
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:To examine the frequency with which quality of life and treatment limitation were discussed in formal family meetings for long-stay intensive care unit patients with high risk for mortality and morbidity. DESIGN:Descriptive observational study. SETTING:Five intensive care units. PATIENTS:One hundred sixtee...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318232d8c4
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that cocaine-induced cerebral vasodilation in newborn sheep is mediated via beta-adrenergic receptor activation. DESIGN:The cerebral effects of a single intravenous injection of cocaine (4 mg/kg) given 30 mins after pretreatment with propranolol (1 mg/kg...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199904000-00036
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:This pilot study was designed to identify which contextual factors facilitate/hinder the implementation of the awakening, breathing, coordination, delirium, and early mobility (ABCDE) bundle for guidance in future studies. DESIGN:The sources of data for this study included document review, planned site visit...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182a2c2b1
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prognostic value of sublingual PCO2 (P(SL)CO2), lactate concentration, and mixed venous oxygen saturation (S(MV)O2) in hemodynamically unstable intensive care patients and, additionally, to compare the temporal changes of these variables in response to treatment....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000054862.74829.EA
更新日期:2003-03-01 00:00:00