Can Peripheral Perfusion Index (PPI) Predict Disease Severity in COVID-19 Patients in the Emergency Department?

Korkut, Mustafa; Bedel, Cihan; Selvi, Fatih; Zortuk, Ökkeş

doi:10.1055/s-0042-1748776

Cited by 3 publications

(1 citation statement)

References 29 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Korkut and cols. demonstrated a positive correlation between the severity of SARS-Cov2 infection and the intensity of peripheral vasoconstriction assessed with PPI [24]. Furthermore, they demonstrated that PPI can be used to discriminate the more severe COVID-19 patients admitted to the emergency department [24].…”

Section: Discussionmentioning

confidence: 97%

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-cov-2) Infection: An Exploratory Analysis With Near-infrared Spectroscopy

Souza

Galindo

Vianna

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: To investigate clinical and laboratory tissue perfusion in addition to near-infrared spectroscopy (NIRS) static and dynamic-derived parameters in critically ill COVID-19 patients. Methods: A cross-sectional single-center exploratory study was performed. Twenty adult patients with confirmed COVID-19 admitted to the intensive care unit (ICU) within 24 hours were prospectively included in this study. A control group without COVID-19 was composed by forty patients included in recently published study. Accessed NIRS-derived parameters included basal tissue oxygen saturation (StO2), descending slope (%/min), ascending slope (%/min), maximum value of StO2 (StO2max), recovery time (s) and the area under the curve of reactive hyperemia. Results: The median (IQR) age of included patients was 58 (46-69) years. Patients with COVID-19 presented higher SAPS III score [50 (46-53) vs. 45 (30-53), p=0.04] compared with control patients. Patients with SARS-CoV-2 infection showed higher StO2 min [60 (49-79) vs. 54 (48-58) %; p=0.04] and lower descending slope [5.7 (3.4-8.8) vs. 8.1 (6.4-9.7) %/min; p<0.01] compared with ICU patients without COVID-19. Basal StO2 [80 (74-90) vs. 82 (76-86) %; p=0.89], StO2 max [(91 (83-95) vs. 90 (84-94) %; p=0.86], ascending slope [2.0 (1.1-2.9) vs. 2.2 (1.5-3.3) %/min; p=0.43], recovery time [14.5 (12.0-22.0) vs. 21.5 (14.3-28.3) s; p=0.13] and hyperemia area [10.3 (5.8-13.0) vs. 8.6 (4.0-14.3); p=0.55] did not differ between, respectively, COVID-19 and control groups. Conclusion: Severe COVID-19 patients exhibited a lower rate of oxygen extraction by peripheral tissues than non-COVID-19 critically ill patients, which may represent an adaptive mechanism to hypoxemia. This hypothesis needs to be further investigated.

show abstract

Section: Discussionmentioning

confidence: 97%

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-cov-2) Infection: An Exploratory Analysis With Near-infrared Spectroscopy

Souza

Galindo

Vianna

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

Can chest computed tomography be useful to emergency residents in the diagnosis of COVID-19 pneumonia?

Kozak,

Bektaş,

Korkut

et al. 2023

J CLIN MED KAZ

View full text Add to dashboard Cite

Aim: During the novel coronavirus disease (COVID-19) pandemic, the workload of emergency department residents (ER) has increased since emergency departments (EDs) are among the first health units to which patients apply. The aim of this study was to investigate the diagnostic value of chest computed tomography (CT) interpretations of emergency department residents in the diagnosis of COVID-19 pneumonia. Material and methods: Patients who admitted to the tertiary ED between 30.03.2020 and 30.12.2020 with suspected COVID-19 pneumonia and underwent chest CT imaging were retrospectively analyzed. Chest CT images previously reported by the radiologist were reinterpreted by the ER and the diagnostic performance of the ER for COVID-19 pneumonia was calculated. Results: The study included 2045 patients with suspected COVID-19 pneumonia. Chest CT images of all patients were interpreted and compared by a radiologist and the ER In this study, interpretation by a radiologist was considered as the gold standard. In all patients, the diagnostic performance capacity of ER for COVID-19 pneumonia included a low sensitivity of 66%, a high specificity of 92%, a positive predictive value (PPV) of 83% and a negative predictive value (NPV) of 82%. When patients with positive COVID-19 RT-PCR test results were analyzed, the highest sensitivity, specificity, PPV and NPV of ER were 96%, 82%, 95%, 95% and 86%, respectively. Conclusion: ER detected COVID-19 pneumonia in COVID-19 (+) patients with high diagnostic value and excluded inconsistent findings. Chest CT interpretation in the ER has a high diagnostic value. It is as important as any other radiologist in outbreak management in the ED.

show abstract

Peripheral perfusion index in critically ill COVID-19 and its association with multiorgan dysfunction

Cornu Matias,

Tonelier,

Roel

et al. 2023

J Clin Intensive Care Med

View full text Add to dashboard Cite

Introduction: Severe cases of COVID-19 presented a high incidence of multi-organ dysfunction syndrome (MODS) during their evolution. This was attributed to a theoretical cytokine storm, where microcirculatory disorders would play a fundamental role, causing these patients to present a sepsis-like pattern as observed in sublingual microcirculation studies. The evidence in this regard is controversial. The Peripheral Perfusion Index is a reliable method to continuously and non-invasively assess the microcirculatory bed, which assesses the pulsatile (PPI) component of the plethysmographic pulse curve. Methods: We conducted a prospective observational study to evaluate the behavior of the PPI in patients with severe respiratory failure due to SARS-CoV-2 and its association with SDOM. Results: We evaluated 60 patients with APACHE II 14.6 ± 4.4 and SOFA 4.7 ± 2.1. 55% of the patients presented SDOM. Perfusion monitoring showed IP values of 5.32 ± 1.87 that were associated with normal lactate levels of 1.49 mmol/L (min 0.89/ max 2.20 mmol/L). The PPI values between the living and the dead did not show a significant difference (p = 0.854) or the presence of SDOM. The PPI values between the patients who presented renal failure, hemodynamics, or perfusion disorders were determined by the presence of hyperlactatemia, and for those who did not present these characteristics, no statistical difference was found; neither when stratified by PaFiO2 ratio. Mortality was 55%. Conclusion: In our series of patients with severe pneumonia due to COVID-19, we found high PPI values, which would correspond to a pattern of capillary recruitment, and the associated organ injury could not be substantiated by this phenomenon.

show abstract

Can Peripheral Perfusion Index (PPI) Predict Disease Severity in COVID-19 Patients in the Emergency Department?

Cited by 3 publications

References 29 publications

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-cov-2) Infection: An Exploratory Analysis With Near-infrared Spectroscopy

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-cov-2) Infection: An Exploratory Analysis With Near-infrared Spectroscopy

Can chest computed tomography be useful to emergency residents in the diagnosis of COVID-19 pneumonia?

Peripheral perfusion index in critically ill COVID-19 and its association with multiorgan dysfunction

Contact Info

Product

Resources

About