低外周灌注指数可准确检测全身麻醉期间延长的毛细血管再充盈时间：一项前瞻性观察研究。

A low peripheral perfusion index can accurately detect prolonged capillary refill time during general anesthesia: A prospective observational study.

作者信息

Iizuka Yusuke, Yoshinaga Koichi, Nakatomi Takeshi, Takahashi Kyosuke, Yoshida Kyoko, Sanui Masamitsu

机构信息

Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya-ku, Saitama City, Saitama, 330-8503, Japan.

出版信息

Saudi J Anaesth. 2023 Jan-Mar;17(1):33-38. doi: 10.4103/sja.sja_634_22. Epub 2023 Jan 2.

DOI:10.4103/sja.sja_634_22

PMID:37032676

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10077788/

Abstract

BACKGROUND

Capillary refill time (CRT) is the gold standard for evaluating peripheral organ perfusion; however, intraoperative CRT measurement is rarely used because it cannot be conducted continuously, and it is difficult to perform during general anesthesia. The peripheral perfusion index (PI) is another noninvasive method for evaluating peripheral perfusion. The PI can easily and continuously evaluate peripheral perfusion and could be an alternative to CRT for use during general anesthesia. This study aimed to determine the cutoff PI value for low peripheral perfusion status (prolonged CRT) by exploring the relationship between CRT and the PI during general anesthesia.

METHODS

We enrolled 127 surgical patients. CRT and the PI were measured in a hemodynamically stable state during general anesthesia. A CRT >3 s indicated a low perfusion status.

RESULTS

Prolonged CRT was observed in 27 patients. The median PI values in the non-prolonged and prolonged CRT groups were 5.0 (3.3-7.9) and 1.5 (1.2-1.9), respectively. There was a strong negative correlation between the PI and CRT ( = -0.706). The area under the receiver operating characteristic curve generated for the PI was 0.989 (95% confidence interval, 0.976-1.0). The cutoff PI value for detecting a prolonged CRT was 1.8.

CONCLUSION

A PI <1.8 could accurately predict a low perfusion status during general anesthesia in the operating room. A PI <1.8 could be used to alert the possibility of a low perfusion status in the operating room.

TRIAL REGISTRATION

University Hospital Medical Information Network (UMIN000043707; retrospectively registered on March 22, 2021, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno = R000049905).

摘要

背景

毛细血管再充盈时间（CRT）是评估外周器官灌注的金标准；然而，术中CRT测量很少被使用，因为它无法连续进行，并且在全身麻醉期间难以实施。外周灌注指数（PI）是评估外周灌注的另一种非侵入性方法。PI可以轻松且连续地评估外周灌注，并且可能是全身麻醉期间CRT的替代方法。本研究旨在通过探索全身麻醉期间CRT与PI之间的关系，确定低外周灌注状态（CRT延长）的临界PI值。

方法

我们纳入了127例手术患者。在全身麻醉期间血流动力学稳定状态下测量CRT和PI。CRT>3秒表明灌注状态低。

结果

27例患者观察到CRT延长。非延长和延长CRT组的中位PI值分别为5.0（3.3 - 7.9）和1.5（1.2 - 1.9）。PI与CRT之间存在强负相关（=-0.706）。PI生成的受试者工作特征曲线下面积为0.989（95%置信区间，0.976 - 1.0）。检测CRT延长的临界PI值为1.8。