Abstract
Background: Assessment of microcirculation during fluid resuscitation of septic shock patients mainly relay on the serum lactate level and routine clinical bed-side tests (as CRT). New techniques for evaluation of tissue perfusion have been developed -remote photoplethysmography (rPPG) and automated objective capillary refill time measurement technique (aCRT).
The Goal of Study: Was to assess changes in peripheral perfusion during fluid resuscitation using remote photoplethysmography and automated capillary refill time in ICU patients with bacterial septic shock and severe Covid-19 patients.
Materials and Methods: Patients with positive passive leg raising test (PLRT) were initially resuscitated with crystalloids (10ml/kg over 60min). Hemodynamic variables, manual capillary refill time (mCRT) and aCRT parameters (T90 –time when 90% of capillary refill is over, Tst –time when capillary refill is fully over), peripheral perfusion index (PPI) detected using rPPG were collected before and after PLRT and after volume expansion (VE)
Results and Discussion: A total of 34 patients were divided into 2 groups:COVID-19 (n=18) and bacterial septic shock (n=16). In COVID-19 mean PPI increased during PLRT by 7% (from 43+/- 27 to 46.5+/-29.1), by 15% after VE(from 43.0+/-27.8 to 49.5+/-22.6), while in septic shock PPI increased during PLRT by 18%(from 28.3 +/-20.9 to 33.6 +/-25.3),by 28% after VE(from 28.3+/- 20.0 to 36.3+/-25.8). Mean mCRT in COVID-19 decreased by 22% during
PLRT (2.57+/- 0.59 to 1.98 +/-0.68),by 22% after VE (from 2.57+/- 0.59 to 1.98+/-0.78), while in septic shock decreased by 31% during PLRT (from 1.85+/-0.64 to1.29+/-0.38),by 32% after VE (from 1.85+/-0.64 to 1.26+/-0.29). Mean aCRT T90 in COVID-19 decreased by 32% during PLRT (from 1.74 +/-1.16 to 1.17+/-0.79),by 17% after VE (from 1.74+/-1.16 to1.45+/-1.06), in septic shock decreased by 41% during PLR (from 1.93+/-1.03 to 1.38 +/-0.79), by 8% after VE (from 1.93 +/- 1.03 to 1.78+/-0.66). Mean Tst in COVID-19 decreased by 21% during PLRT (from 3.33 +/-1.59 to 2.63 +/-1.37),by 10% after VE (from 3.33+/-1.59 to 3.03+/-1.44), in septic shock decreased by 25% during PLRT (from 3.74+/-1.24 to 2.81+/-1.22) by 2% after VE (from 3.74+/-1.24 to 3.69+/-1.12). In COVID-19 lactate level decreased by 10% after VE (from 2.0+/-0.7 to 1.8+/-0.8), in septic shock by 18% (from 2.3+/-1.6 to1.9+/-1.2).
Conclusion: rPPG and aCRT are techniques potentially applicable to assess microcirculation during fluid resuscitation in critically ill patients.
The Goal of Study: Was to assess changes in peripheral perfusion during fluid resuscitation using remote photoplethysmography and automated capillary refill time in ICU patients with bacterial septic shock and severe Covid-19 patients.
Materials and Methods: Patients with positive passive leg raising test (PLRT) were initially resuscitated with crystalloids (10ml/kg over 60min). Hemodynamic variables, manual capillary refill time (mCRT) and aCRT parameters (T90 –time when 90% of capillary refill is over, Tst –time when capillary refill is fully over), peripheral perfusion index (PPI) detected using rPPG were collected before and after PLRT and after volume expansion (VE)
Results and Discussion: A total of 34 patients were divided into 2 groups:COVID-19 (n=18) and bacterial septic shock (n=16). In COVID-19 mean PPI increased during PLRT by 7% (from 43+/- 27 to 46.5+/-29.1), by 15% after VE(from 43.0+/-27.8 to 49.5+/-22.6), while in septic shock PPI increased during PLRT by 18%(from 28.3 +/-20.9 to 33.6 +/-25.3),by 28% after VE(from 28.3+/- 20.0 to 36.3+/-25.8). Mean mCRT in COVID-19 decreased by 22% during
PLRT (2.57+/- 0.59 to 1.98 +/-0.68),by 22% after VE (from 2.57+/- 0.59 to 1.98+/-0.78), while in septic shock decreased by 31% during PLRT (from 1.85+/-0.64 to1.29+/-0.38),by 32% after VE (from 1.85+/-0.64 to 1.26+/-0.29). Mean aCRT T90 in COVID-19 decreased by 32% during PLRT (from 1.74 +/-1.16 to 1.17+/-0.79),by 17% after VE (from 1.74+/-1.16 to1.45+/-1.06), in septic shock decreased by 41% during PLR (from 1.93+/-1.03 to 1.38 +/-0.79), by 8% after VE (from 1.93 +/- 1.03 to 1.78+/-0.66). Mean Tst in COVID-19 decreased by 21% during PLRT (from 3.33 +/-1.59 to 2.63 +/-1.37),by 10% after VE (from 3.33+/-1.59 to 3.03+/-1.44), in septic shock decreased by 25% during PLRT (from 3.74+/-1.24 to 2.81+/-1.22) by 2% after VE (from 3.74+/-1.24 to 3.69+/-1.12). In COVID-19 lactate level decreased by 10% after VE (from 2.0+/-0.7 to 1.8+/-0.8), in septic shock by 18% (from 2.3+/-1.6 to1.9+/-1.2).
Conclusion: rPPG and aCRT are techniques potentially applicable to assess microcirculation during fluid resuscitation in critically ill patients.
| Original language | English |
|---|---|
| Pages (from-to) | 293-294 |
| Journal | European Journal of Anaesthesiology |
| Volume | 40 |
| Issue number | Suppl.61 |
| Publication status | Published - Jun 2023 |
| Event | Euroanaesthesia 2023 - The European Anaesthesiology Congress: The EBA Controversy sessions “The Future of Anaesthesiology - Nurses, Robots, or Anaesthesiologists” - Scottish Event Campus, Exhibition Way, Glasgow, United Kingdom Duration: 3 Jun 2023 → 5 Jun 2023 https://euroanaesthesia.org/2023/#:~:text=Congress%20Dates&text=This%20year%2C%20Euroanaesthesia%20will%20be,online%20for%20the%20virtual%20event. https://euroanaesthesia.org/2023/ |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)