毛细血管再充盈时间测量仪在重症患者中的应用价值初探

doi:10.3969/j.issn.1002-1949.2019.10.013

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (10): 981-986 DOI: 10.3969/j.issn.1002-1949.2019.10.013

Preliminary study on the application value of capillary refill time measuring instrument in severe patients

Chen Rui, Lai Jia-hua, Xie Zhi-yi, Wang Zhong

Clinical Medical College, Tsinghua University, Beijing 100084, China

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Abstract Objective To explore the application value of capillary refill time(CRT) measuring instrument in critical patients. Methods A prospective cohort study was conducted to enroll severe patients in the Department of Critical Care Medicine, Tsinghua Changgeng Hospital, Beijing, from January 2019 to February 2019. The patients were divided into shock group and non-shock group according to whether they had shock or not. CRTauto, b and k parameters were measured by capillary refill time measuring instrument, and capillary refill time(CRT) was also measured by clinicians. CRT, temperature difference between forearm and fingertip, mottling score, peripheral perfusion index(PPI), lactate, MAP, CVP, ScvO2, CI, SOFA score, APACHEⅡ score, 28-day survival, ICU hospitalization time were recorded. The database was established for statistical analysis. Results A total of 134 severe patients were included in this study for statistical analysis. There were 35 shock patients and 99 non-shock patients. 79% of patients over 65 years old are difficult to use naked eye to measure CRT because of too thick nail bed and jaundice. For patients who can measure CRT by naked eye, the correlation between CRT measured by naked eye and CRTauto measured by machine was good, the Pearson correlation coefficient was 0.866. CRTauto was prolonged in elderly patients and diabetic patients in non-shock group (P＜0.05). The diagnostic value of CRTauto for shock patients was similar to that of blood lactic acid (the area under ROC curve was 0.905 vs. 0.879). CRTauto had a cutoff value of 3438 ms with the largest Yoden index, its sensitivity and specificity for shock diagnosis were 80.0% and 85.7%. The sensitivity and specificity of b and k values for shock diagnosis were not good. CRTauto had good correlation with APACHE Ⅱ score and SOFA score of severe patients, Pearson coefficient was 0.691 and 0.643 respectively (P＜0.05). Conclusion CRTauto is reliable and practical measuring by capillary refill time measuring instrument. CRTauto has a good diagnostic value for shock patients, and is related to the severity of severe patients, and there is a good application value. The measurement and clinical use of b and k parameters need further equipment improvement and clinical research.

Key words： Capillary refill time(CRT) Standardized measurement Peripheral circulation Severe patients

Corresponding Authors: Wang Zhong, E-mail: Wangzhong523@vip.163.com

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Cite this article:

Chen Rui,Lai Jia-hua,Xie Zhi-yi, et al. Preliminary study on the application value of capillary refill time measuring instrument in severe patients[J]. Chinese Journal of Critical Care Medicine, 2019, 39(10): 981-986.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.10.013 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I10/981

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