The peripheral perfusion index and transcutaneous oxygen challenge test are predictive of mortality in septic patients after resuscitation

He, Huaiwu; Liu, Dawei; Long, Yun; Wang, Xiaoting

doi:10.1186/cc12788

Cited by 80 publications

(54 citation statements)

References 37 publications

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“…PI has a cut-off value of <0.2 for predicting ICU mortality, which is similar to that previously shown by He et al (21). They demonstrated that a PI of 0.2 during early resuscitation in septic patients had a sensitivity of 65% and a specificity of 92% for predicting ICU mortality.…”

Section: Discussionsupporting

confidence: 72%

Evaluation of Perfusion Index as a Predictor of Vasopressor Requirement in Patients with Severe Sepsis

Rasmy

Mohamed

Nabil

et al. 2015

Shock

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We evaluated the ability of perfusion index (PI) to predict vasopressor requirement during early resuscitation in patients with severe sepsis. All consecutive patients with clinically suspected severe sepsis as defined by the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference were included. Perfusion variables included PI, arterial lactate level, central venous oxygen saturation, and the difference between central venous carbon dioxide and arterial carbon dioxide pressures, and were recorded before resuscitation and 6 h thereafter. We enrolled 36 patients with severe sepsis. Twenty-one patients required vasopressors, whereas 15 did not. The cut-off of the PI value for predicting vasopressor requirement was ≤0.3. This cut-off value had a sensitivity of 100% and a specificity of 93%; the area under the curve was 0.96 (95% confidence interval 0.8-0.99, P < 0.0001). The cut-off of the arterial lactate level for predicting vasopressor requirement was ≥1.8 mg dL. This cut-off value had a sensitivity of 82% and a specificity of 80%; the area under the curve was 0.84 (95% confidence interval 0.68-0.94, P < 0.0001). Other perfusion variables failed to predict vasopressor requirement in patients with severe sepsis. We concluded that PI and arterial lactate level are good predictors of vasopressor requirement during early resuscitation in patients with severe sepsis. Further studies are warranted to investigate whether monitoring PI during resuscitation improves the outcome of patients with septic shock.

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Section: Discussionsupporting

confidence: 72%

Evaluation of Perfusion Index as a Predictor of Vasopressor Requirement in Patients with Severe Sepsis

Rasmy

Mohamed

Nabil

et al. 2015

Shock

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“…A newer parameter, the oxygen challenge test (OCT), was reported as a tool for early diagnosis of poor peripheral perfusion [48, 62, 63]. OCT the Ptco 2 response to increasing Fio 2 to 1 for a 5-min duration.…”

Section: Markers Of Local Perfusionmentioning

confidence: 99%

Perfusion indices revisited

2017

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Monitoring of tissue perfusion is an essential step in the management of acute circulatory failure. The presence of cellular dysfunction has been a basic component of shock definition even in the absence of hypotension. Monitoring of tissue perfusion includes biomarkers of global tissue perfusion and measures for assessment of perfusion in non-vital organs.The presence of poor tissue perfusion in a shocked patient is usually associated with worse outcome. Persistently impaired perfusion despite adequate resuscitation is also associated with worse outcome. Thus, normalization of some perfusion indices has become one of the resuscitation targets in patients with septic shock.Although the collective evidence shows the clear relation between impaired peripheral perfusion and mortality, the use of different perfusion indices as a resuscitation target needs more research.

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“…Compared to other indicators that are used in guiding shock treatment, PPI is non-invasive and realtime. Studies on PPI have confirmed its significance on reflecting tissue perfusion in critically ill patients [6,15,16].…”

Section: Roc Analysesmentioning

confidence: 94%

Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

Shi¹,

Xu²,

Yu³

et al. 2020

Preprint

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BackgroundPeripheral perfusion index (PPI) is associated with hypoperfusion in critical patients. Many researches focus on using PPI as a predictor in septic shock, but few studies report on its significance in surgical patients. We performed this study to find out association between PPI and surgical patients' prognoses. MethodsIt's a retrospective study from January to June 2019, on surgical patients transferred to ICU, Xinyang Central hospital, Henan province, China. The inclusive/exclusive criteria are followings, inclusive:1) age ≥18 years old; 2) surgical length ≥120min; Exclusive: 1) died in ICU; 2) discharging against medical advice; 3) existing diseases affecting blood flow of upper limbs, for example, vascular thrombus in arms; 4) severe liver dysfunction Patients were grouped according to their length of ICU stay (LOS ICU, >48h regarded as prolonged ICU stay, otherwise non-prolonged). Baseline characteristics (age, gender, comorbidity), surgical sites and length, SOFA and APACHE II on 1st day in ICU, LOS ICU, mean artery pressure (MAP), lactate clearance rate (LCR), peripheral perfusion index (PPI), temperature (axillary) were collected and compared between the 2 groups. Correlation and ROC (receiver operating characteristic) analysis was also performed. ResultsEventually, 72 patients were included, 30 in prolonged and 42 in non-prolonged group. Compared to non-prolong, patients in prolonged ICU stay group had higher lactate(6h: 3.70±0.52 vs 2.50±0.59 mmol/L, p<0.001; 12h: 2.78±0.50 vs 1.90±0.30 mmol/L, p<0.001), lower LCR(0-6h: -20%[-37%, 0%] vs 19%[9%, 31%], p<0.001) and PPI (0h: 0.80± 0.27 vs 1.47±0.43, p<0.001; 6h: 0.88±0.25 vs 1.57±0.40, p<0.001). No difference was found in gender, age, surgical length, SOFA, APACHE II, temperature and comorbidity. Averaged 1h and 6h PPI were strongly associated with LCR (0-6h, correlation coefficient 0.5521h and 0.4366h) and LOS ICU(correlation coefficient: -0.6391h and -0.5606h). The area under the receiver operating characteristic (AUC) of PPIT0 and PPIT1 for predicting prolonged ICU stay were 0.905 and 0.916 respectively. The cutoff values of PPIT0 and

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The peripheral perfusion index and transcutaneous oxygen challenge test are predictive of mortality in septic patients after resuscitation

Cited by 80 publications

References 37 publications

Evaluation of Perfusion Index as a Predictor of Vasopressor Requirement in Patients with Severe Sepsis

Evaluation of Perfusion Index as a Predictor of Vasopressor Requirement in Patients with Severe Sepsis

Perfusion indices revisited

Peripheral perfusion index predicting early hypoperfusion, reflecting lactate clearance rate and length of ICU stay in surgical patients: an observational study

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