Accuracy of Bedside Glucometry in Critically Ill Patients: Influence of Clinical Characteristics and Perfusion Index

2008 ◽  
Vol 83 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Arnaud Desachy ◽  
Albert C. Vuagnat ◽  
Aiham D. Ghazali ◽  
Olivier T. Baudin ◽  
Olivier H. Longuet ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Perfusion Index

scholarly journals Evaluation of peripheral perfusion index and heart rate variability as early predictors for intradialytic hypotension in critically ill patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hanan Mostafa ◽  
Mohamed Shaban ◽  
Ahmed Hasanin ◽  
Hassan Mohamed ◽  
Shymaa Fathy ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Pulmonary Oedema ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Perfusion Index ◽  
Intradialytic Hypotension ◽  
Peripheral Perfusion ◽  
Hemodialysis Session ◽  
Prophylactic Measures

Abstract Background Intradialytic hypotension is a serious complication during renal replacement therapy in critically ill patients. Early prediction of intradialytic hypotension could allow adequate prophylactic measures. In this study we evaluated the ability of peripheral perfusion index (PPI) and heart rate variability (HRV) to predict intradialytic hypotension. Methods A prospective observational study included 36 critically ill patients with acute kidney injury during their first session of intermittent hemodialysis. In addition to basic vital signs, PPI was measured using Radical-7 (Masimo) device. Electrical cardiometry (ICON) device was used for measuring cardiac output, systemic vascular resistance, and HRV. All hemodynamic values were recorded at the following time points: 30 min before the hemodialysis session, 15 min before the start of hemodialysis session, every 5 min during the session, and 15 min after the conclusion of the session. The ability of all variables to predict intradialytic hypotension was assessed through area under receiver operating characteristic (AUROC) curve calculation. Results Twenty-three patients (64%) had intradialytic hypotension. Patients with pulmonary oedema showed higher risk for development of intradialytic hypotension {Odds ratio (95% CI): 13.75(1.4–136)}. Each of baseline HRV, and baseline PPI showed good predictive properties for intradialytic hypotension {AUROC (95% CI): 0.761(0.59–0.88)}, and 0.721(0.547–0.857)} respectively. Conclusions Each of low PPI, low HRV, and the presence of pulmonary oedema are good predictors of intradialytic hypotension.

Clinical characteristics of critically ill patients with suspected influenza during the 2009-10 and 2013-14 outbreaks

2017 ◽  
Vol 38 ◽  
pp. 73-77
Author(s):  
Miguel J. Franquiz ◽  
Paul G. Saleeb ◽  
Carl B. Shanholtz ◽  
Jeffrey P. Gonzales
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics

Peripheral Perfusion Index Predicts Hypotension during Fluid Withdrawal by Continuous Veno-Venous Hemofiltration in Critically Ill Patients

2015 ◽  
Vol 40 (1) ◽  
pp. 92-98 ◽  
Author(s):  
Eva Klijn ◽  
A.B. Johan Groeneveld ◽  
Michel E. van Genderen ◽  
Michiel Betjes ◽  
Jan Bakker ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Perfusion Index ◽  
Tissue Oxygen Saturation ◽  
Peripheral Perfusion ◽  
Tissue Oxygen ◽  
Infra Red ◽  
Hypovolemic Hypotension

Aim: Peripheral perfusion may predict harmful hypovolemic hypotension during fluid withdrawal by continuous veno-venous hemofiltration (CVVH) in critically ill patients with acute kidney injury. Methods: Twenty-three critically ill AKI patients were subjected to progressive fluid withdrawal. Systemic hemodynamics and peripheral perfusion index (PPI) by pulse oximetry, forearm-to-fingertip skin temperature gradient (Tskin-diff) and tissue oxygen saturation (StO2, near infra-red spectroscopy) were measured. Results: Most hemodynamic values decreased with fluid withdrawal, particularly in the hypotensive group, except for stroke volume (SV) and cardiac output, which decreased to a great extent in the non-hypotensive patients. Increases in systemic vascular resistance (SVR) were less in hypotension. Baseline pulse pressure and PPI were lower in hypotensive (n = 10) than non-hypotensive patients and subsequent PPI values paralleled SV decreases. A baseline PPI ≤0.82 AU predicted hypotension with a sensitivity of 70%, and a specificity of 92% (AUC 0.80 ± 0.11, p = 0.004). Conclusion: Progressive fluid withdrawal during CVVH is poorly tolerated in patients with less increases in SVR. The occurrence of hypotension can be predicted by low baseline PPI.

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