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: Koichiro Shinozaki, Lee S. Jacobson, Kota Saeki, Hideaki Hirahara, Naoki Kobayashi, Steve Weisner, Julianne M. Falotico, Timmy Li, Junhwan Kim, Lance B. Becker
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Journal of Intensive Care, Vol 7, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 2052-0492
DOI: 10.1186/s40560-019-0406-0
Popis: Abstract Background Traditional 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 methods An 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. Results Thirty 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. Conclusions BRT 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: Directory of Open Access Journals
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