PMID- 35849736
OWN - NLM
STAT- MEDLINE
DCOM- 20221118
LR  - 20221221
IS  - 1535-4970 (Electronic)
IS  - 1073-449X (Linking)
VI  - 206
IP  - 10
DP  - 2022 Nov 15
TI  - Performance of Early Capillary Refill Time Measurement on Outcomes in Cardiogenic 
      Shock: An Observational, Prospective Multicentric Study.
PG  - 1230-1238
LID - 10.1164/rccm.202204-0687OC [doi]
AB  - Rationale: Identification of cardiogenic shock severity is a critical step to 
      adapt the management level upon admission. Peripheral tissue perfusion signs, 
      simple and reliable markers of tissue hypoperfusion have never been extensively 
      assessed during cardiogenic shock. Objectives: To assess the correlation of 
      capillary refill time values with 90-day mortality in cardiogenic shock patients 
      or the need for venoarterial extracorporeal membrane oxygenation (VA-ECMO) 
      support. Also to assess the correlation between capillary refill time and 
      hemodynamic parameters. Methods: All consecutive patients with cardiogenic shock 
      admitted to the intensive care unit of two tertiary teaching hospitals were 
      included in a prospective observational study. Macro-hemodynamic parameters (such 
      as heart rate, blood pressure, left ventricular ejection fraction, and cardiac 
      index) and peripheral tissue perfusion signs, such as capillary refill time on 
      the index fingertip, mottling, and Pv-aCO(2) (the difference between partial 
      pressure of CO(2) between venous and arterial blood) were recorded at inclusion 
      (0 hour), 6 hours, 12 hours, 24 hours, and 48 hours. The composite primary 
      endpoint was the association between 90-day mortality or the need for VA-ECMO 
      support. Measurements and Main Results: A total of 61 patients were included; at 
      inclusion, simplified acute physiology score II was 64 (52-77) points. The 
      primary endpoint was met by 42% of patients. Capillary refill time values were 
      significantly higher at all time points in nonsurvivors or patients needing 
      VA-ECMO support. In univariate analysis, capillary refill time > 3 seconds at 
      inclusion was associated with 90-day all-cause mortality or VA-ECMO support 
      (hazard ratio, 12.38; 95% confidence interval, 2.91-52.71). Capillary refill time 
      at inclusion was poorly associated with macrocirculatory parameters but 
      significantly correlated with microcirculatory parameters. Further, capillary 
      refill time added incremental value to Cardshock score, with an AUC combination 
      at 0.93. Conclusions: In patients with cardiogenic shock admitted to the ICU, our 
      preliminary data suggest that a prolonged capillary refill time >3 seconds was 
      associated with an early prediction of 90-day mortality or the need for VA-ECMO 
      support.
FAU - Merdji, Hamid
AU  - Merdji H
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
AD  - INSERM (French National Institute of Health and Medical Research), Unite Mixte de 
      Recherche (UMR) 1260, Regenerative Nanomedicine, Strasbourg, France.
FAU - Curtiaud, Anais
AU  - Curtiaud A
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
FAU - Aheto, Antoine
AU  - Aheto A
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
FAU - Studer, Antoine
AU  - Studer A
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
FAU - Harjola, Veli-Pekka
AU  - Harjola VP
AD  - Emergency Medicine, University of Helsinki, Helsinki, Finland.
AD  - Department of Emergency Medicine and Services, Helsinki University Hospital, 
      Helsinki, Finland.
FAU - Monnier, Alexandra
AU  - Monnier A
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
FAU - Duarte, Kevin
AU  - Duarte K
AD  - Centre d'Investigations Cliniques Plurithematique, INSERM 1433; Medical Intensive 
      Care Unit Brabois, France.
FAU - Girerd, Nicolas
AU  - Girerd N
AD  - Centre d'Investigations Cliniques Plurithematique, INSERM 1433; Medical Intensive 
      Care Unit Brabois, France.
FAU - Kibler, Marion
AU  - Kibler M
AD  - Division of Cardiovascular Medicine, Strasbourg University Hospital, Strasbourg, 
      France.
FAU - Ait-Oufella, Hafid
AU  - Ait-Oufella H
AD  - Intensive Care Unit, Saint-Antoine Hospital, Assistance Publique-Hopitaux de 
      Paris, Paris, France.
AD  - INSERM U970, Cardiovascular Research Center, Universite de Paris, Paris, France.
FAU - Helms, Julie
AU  - Helms J
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
AD  - INSERM (French National Institute of Health and Medical Research), Unite Mixte de 
      Recherche (UMR) 1260, Regenerative Nanomedicine, Strasbourg, France.
FAU - Mebazaa, Alexandre
AU  - Mebazaa A
AD  - Department of Anaesthesiology, Burn and Critical Care, Saint Louis-Lariboisiere 
      University Hospitals, Assistance Publique-Hopitaux de Paris, Paris, France.
AD  - INSERM UMR-S 942, Cardiovascular Markers in Stress Conditions, Federation 
      Hospitalo-Universitaire Promice, University of Paris, Paris, France.
FAU - Levy, Bruno
AU  - Levy B
AD  - INSERM U1116, Universite de Lorraine, Institut Lorrain du Coeur et des Vaisseaux, 
      Centre Hospitalier Regional Universitaire de Nancy, France; and.
FAU - Kimmoun, Antoine
AU  - Kimmoun A
AD  - INSERM U1116, Universite de Lorraine, Institut Lorrain du Coeur et des Vaisseaux, 
      Centre Hospitalier Regional Universitaire de Nancy, France; and.
FAU - Meziani, Ferhat
AU  - Meziani F
AD  - Universite de Strasbourg, Faculte de Medecine; Hopitaux universitaires de 
      Strasbourg, Nouvel Hopital Civil, Service de Medecine Intensive-Reanimation, 
      Strasbourg, France.
AD  - INSERM (French National Institute of Health and Medical Research), Unite Mixte de 
      Recherche (UMR) 1260, Regenerative Nanomedicine, Strasbourg, France.
AD  - Clinical Research in Intensive Care and Sepsis Trial Group for Global Evaluation 
      and Research in Sepsis French Clinical Research Infrastructure Network, France.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Am J Respir Crit Care Med
JT  - American journal of respiratory and critical care medicine
JID - 9421642
SB  - IM
CIN - Am J Respir Crit Care Med. 2022 Nov 15;206(10):1192-1193. PMID: 35976803
MH  - Humans
MH  - *Shock, Cardiogenic/etiology
MH  - Prospective Studies
MH  - Microcirculation
MH  - Stroke Volume
MH  - *Ventricular Function, Left
MH  - Hemodynamics
MH  - Retrospective Studies
OTO - NOTNLM
OT  - cardiogenic shock
OT  - heart failure
OT  - microcirculation
OT  - shock
EDAT- 2022/07/19 06:00
MHDA- 2022/11/19 06:00
CRDT- 2022/07/18 15:02
PHST- 2022/07/19 06:00 [pubmed]
PHST- 2022/11/19 06:00 [medline]
PHST- 2022/07/18 15:02 [entrez]
AID - 10.1164/rccm.202204-0687OC [doi]
PST - ppublish
SO  - Am J Respir Crit Care Med. 2022 Nov 15;206(10):1230-1238. doi: 
      10.1164/rccm.202204-0687OC.