Divatia Jigeeshu V
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Indian J Crit Care Med. 2024 Jan;28(1):18-19. doi: 10.5005/jp-journals-10071-24633.
Skin mottling has been found to be useful as a marker of peripheral hypoperfusion in shock in studies performed on fair-skinned patients. Whether skin mottling may be less apparent in dark-skinned patients, thus limiting its value in this patient population has not been studied. Jog et al. have performed an elegant study addressing this question, which is important and especially relevant to the Indian situation. They found that mottling is not easily visible in dark-skinned Indian patients, and when it becomes apparent, it is associated with a very high mortality. This study also throws up some areas for future research, including interobserver variability in the detection of mottling, and the hemodynamic and microcirculatory parameters associated with the appearance of mottling. Based on this study, the utility of skin mottling as a tool to guide hemodynamic management in severe septic shock in dark-skinned Indian patients is questionable.
Divatia JV. Skin Mottling in Dark-skinned Indian Patients with Severe Septic Shock: A Window to the Circulation or a Closed Door? Indian J Crit Care Med 2024;28(1):18-19.
在对肤色较浅的患者进行的研究中，皮肤花斑已被发现可作为休克时外周灌注不足的标志物。皮肤花斑在肤色较深的患者中是否不太明显，从而限制了其在该患者群体中的价值，尚未得到研究。乔格等人进行了一项出色的研究来解决这个问题，该问题很重要，且与印度的情况尤其相关。他们发现，在肤色较深的印度患者中，花斑不容易被看到，而当它变得明显时，与非常高的死亡率相关。这项研究还提出了一些未来研究的领域，包括花斑检测中的观察者间差异，以及与花斑出现相关的血流动力学和微循环参数。基于这项研究，皮肤花斑作为指导肤色较深的印度患者严重脓毒症休克血流动力学管理工具的效用值得怀疑。
迪瓦蒂亚JV。严重脓毒症休克的肤色较深的印度患者的皮肤花斑：通向循环的窗口还是一扇关闭的门？《印度重症监护医学杂志》2024年；28(1):18 - 19。
