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Abstract：
UNASSIGNED: Blood lactate is a marker of tissue hypoxia while capillary refill time (CRT) is a surrogate of tissue perfusion. Measuring these parameters is recommended for assessing circulatory status and guiding resuscitation. However, blood lactate is not widely available in African emergency departments. Additionally, CRT assessment faces challenges related to its precision and reproducibility. This study aims to evaluate the accuracy of visual CRT(V-CRT) compared to plethysmographic CRT (P-CRT) in predicting lactate levels among septic patients.
UNASSIGNED: This prospective observational study enrolled consecutive patients with sepsis or septic shock over a 6-month period from a tertiary hospital in Marrakech, Morroco. V-CRT and P-CRT were evaluated upon admission, and simultaneous measurements of arterial lactate levels were obtained. The precision of V-CRT and P-CRT in predicting arterial lactate was assessed using ROC curve analysis.
UNASSIGNED: Forty-three patients aged of 64±15 years, of whom 70 % were male, were included in the study. Of these, 23 patients (53 %) had sepsis, and 20 patients (47 %) experienced septic shock. Both V-CRT and P-CRT demonstrated statistically significant correlations with arterial lactate, with correlation coefficients of 0.529 (p < 0.0001) and 0.517 (p = 0.001), respectively. ROC curve analysis revealed that V-CRT exhibited satisfactory accuracy in predicting arterial lactate levels >2 mmol/l, with an area under the curve (AUC) of 0.8 (95 % CI=0.65 - 0.93; p < 0.0001). The prediction ability of P-CRT was lower than V-CRT with an AUC of 0.73 (95 % CI: 0.57-0.89; p = 0.043). The optimal thresholds were determined as 3.4 s for V-CRT (sensitivity = 90 %, specificity = 58 %) and 4.1 s for P-CRT (sensitivity = 85 %, specificity = 62 %).
UNASSIGNED: These findings suggest that the plethysmographic evaluation did not improve the accuracy of CRT for predicting lactate level. However, V-CRT may still serve as a viable surrogate for lactate in septic patients in low-income settings.
UNASSIGNED: This prospective observational study enrolled consecutive patients with sepsis or septic shock over a 6-month period from a tertiary hospital in Marrakech, Morroco. V-CRT and P-CRT were evaluated upon admission, and simultaneous measurements of arterial lactate levels were obtained. The precision of V-CRT and P-CRT in predicting arterial lactate was assessed using ROC curve analysis.
UNASSIGNED: Forty-three patients aged of 64±15 years, of whom 70 % were male, were included in the study. Of these, 23 patients (53 %) had sepsis, and 20 patients (47 %) experienced septic shock. Both V-CRT and P-CRT demonstrated statistically significant correlations with arterial lactate, with correlation coefficients of 0.529 (p < 0.0001) and 0.517 (p = 0.001), respectively. ROC curve analysis revealed that V-CRT exhibited satisfactory accuracy in predicting arterial lactate levels >2 mmol/l, with an area under the curve (AUC) of 0.8 (95 % CI=0.65 - 0.93; p < 0.0001). The prediction ability of P-CRT was lower than V-CRT with an AUC of 0.73 (95 % CI: 0.57-0.89; p = 0.043). The optimal thresholds were determined as 3.4 s for V-CRT (sensitivity = 90 %, specificity = 58 %) and 4.1 s for P-CRT (sensitivity = 85 %, specificity = 62 %).
UNASSIGNED: These findings suggest that the plethysmographic evaluation did not improve the accuracy of CRT for predicting lactate level. However, V-CRT may still serve as a viable surrogate for lactate in septic patients in low-income settings.
摘要：
■血液乳酸是组织缺氧的标志，而毛细血管再充盈时间（CRT）是组织灌注的替代指标。建议测量这些参数以评估循环状态和指导复苏。然而,血乳酸在非洲急诊科并不广泛使用.此外,CRT评估面临着与其准确性和可重复性相关的挑战。这项研究旨在评估视觉CRT（V-CRT）与体积描记术CRT（P-CRT）在预测败血症患者乳酸水平方面的准确性。
这项前瞻性观察性研究纳入了马拉喀什三级医院连续6个月的脓毒症或脓毒性休克患者，Morroco.入院时对V-CRT和P-CRT进行评估，并同时测量动脉乳酸水平。使用ROC曲线分析评估V-CRT和P-CRT预测动脉乳酸的准确性。
■43名年龄为64±15岁的患者，其中70%是男性，包括在研究中。其中,23例患者（53%）有败血症，和20例患者（47％）经历了脓毒性休克。V-CRT和P-CRT均与动脉乳酸具有统计学意义，相关系数为0.529(p<0.0001)和0.517(p=0.001)，分别。ROC曲线分析显示，V-CRT在预测动脉乳酸水平>2mmol/l方面表现出令人满意的准确性，曲线下面积（AUC）为0.8（95％CI=0.65-0.93；p<0.0001）。P-CRT的预测能力低于V-CRT，AUC为0.73（95％CI：0.57-0.89；p=0.043）。V-CRT的最佳阈值确定为3.4s(灵敏度=90%，特异性=58%)和P-CRT的4.1s(灵敏度=85%，特异性=62%)。
■这些研究结果表明，体积描记评估并没有提高CRT预测乳酸水平的准确性。然而,在低收入环境中，V-CRT仍可作为脓毒症患者乳酸的可行替代品。
这项前瞻性观察性研究纳入了马拉喀什三级医院连续6个月的脓毒症或脓毒性休克患者，Morroco.入院时对V-CRT和P-CRT进行评估，并同时测量动脉乳酸水平。使用ROC曲线分析评估V-CRT和P-CRT预测动脉乳酸的准确性。
■43名年龄为64±15岁的患者，其中70%是男性，包括在研究中。其中,23例患者（53%）有败血症，和20例患者（47％）经历了脓毒性休克。V-CRT和P-CRT均与动脉乳酸具有统计学意义，相关系数为0.529(p<0.0001)和0.517(p=0.001)，分别。ROC曲线分析显示，V-CRT在预测动脉乳酸水平>2mmol/l方面表现出令人满意的准确性，曲线下面积（AUC）为0.8（95％CI=0.65-0.93；p<0.0001）。P-CRT的预测能力低于V-CRT，AUC为0.73（95％CI：0.57-0.89；p=0.043）。V-CRT的最佳阈值确定为3.4s(灵敏度=90%，特异性=58%)和P-CRT的4.1s(灵敏度=85%，特异性=62%)。
■这些研究结果表明，体积描记评估并没有提高CRT预测乳酸水平的准确性。然而,在低收入环境中，V-CRT仍可作为脓毒症患者乳酸的可行替代品。
