Comparison of point-of-care peripheral perfusion assessment using pulse oximetry sensor with manual capillary refill time: clinical pilot study in the emergency department
| Autor: | Timmy Li, Steve Weisner, Naoki Kobayashi, Koichiro Shinozaki, Junhwan Kim, Hideaki Hirahara, Kota Saeki, Lance B Becker, Julianne M. Falotico, Lee S. Jacobson |
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| Rok vydání: | 2019 |
| Předmět: |
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Capillary refill time Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Peripheral perfusion Medicine Visual assessment Point of care Receiver operating characteristic medicine.diagnostic_test business.industry Research Investigational Device Peripheral perfusion status lcsh:Medical emergencies. Critical care. Intensive care. First aid ED attending physician 030208 emergency & critical care medicine Outcome prediction lcsh:RC86-88.9 Emergency department Capillary refill Pulse oximetry 030228 respiratory system business Nuclear medicine |
| Zdroj: | Journal of Intensive Care, Vol 7, Iss 1, Pp 1-9 (2019) Journal of Intensive Care |
| ISSN: | 2052-0492 |
| Popis: | BackgroundTraditional capillary refill time (CRT) is a manual measurement that is commonly used by clinicians to identify deterioration in peripheral perfusion status. Our study compared a novel method of measuring peripheral perfusion using an investigational device with standardized visual CRT and tested the clinical usefulness of this investigational device, using an existing pulse oximetry sensor, in an emergency department (ED) setting.Material and methodsAn ED attending physician quantitatively measured CRT using a chronometer (standardized visual CRT). The pulse oximetry sensor was attached to the same hand. Values obtained using the device are referred to as blood refill time (BRT). These techniques were compared in its numbers with the Bland-Altman plot and the predictability of patients’ admissions.ResultsThirty ED patients were recruited. Mean CRT of ED patients was 1.9 ± 0.8 s, and there was a strong correlation with BRT (r= 0.723,p< 0.001). The Bland-Altman plot showed a proportional bias pattern. The ED physician identified 3 patients with abnormal CRT (> 3 s). Area under the receiver operator characteristic curve (AUC) of BRT to predict whether or not CRT was greater than 3 s was 0.82 (95% CI, 0.58–1.00). Intra-rater reliability of BRT was 0.88 (95% CI, 0.79–0.94) and that of CRT was 0.92 (0.85–0.96). Twelve patients were admitted to the hospital. AUC to predict patients’ admissions was 0.67 (95% CI, 0.46–0.87) by BRT and 0.76 (0.58–0.94) by CRT.ConclusionsBRT by a pulse oximetry sensor was an objective measurement as useful as the standardized CRT measured by the trained examiner with a chronometer at the bedside. |
| Databáze: | OpenAIRE |
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