Digital Capillary Refill for Monitoring of Sepsis

Study Overview
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Brief Summary
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Observational study for monitoring of capillary refill time in sepsis

Detailed Description
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This is an observational studying assessing changes in capillary refill time over the course of sepsis treatment.

Official Title
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Digital Capillary Refill for Monitoring of Sepsis

Conditions
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Sepsis

Intervention / Treatment
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* Device: Capillary Refill Assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical evidence of a known or suspected infection and orders written for administration of IV antibiotics Hypotension as defined by the need for any vasopressor (and 1 liter of fluid already administered) OR respiratory failure defined by assisted ventilation (includes mechanical ventilation and BIPAP), CPAP, or greater than or equal to 6 liters/minute of supplemental oxygen Exclusion Criteria: No consent/inability to obtain consent from the participant or a legally authorized representative Diagnosis of cirrhosis by medical chart review Liver transplant recipient AST or ALT greater than five times upper limit of normal Diagnosis of ongoing chronic alcohol use disorder/abuse by chart review; if medical record unclear, use Appendix F Clinical diagnosis of diabetic ketoacidosis or other condition such as profound hypoglycemia that requires hourly blood glucose monitoring Hypersensitivity to Acetaminophen or Vitamin C Patient, surrogate or physician not committed to full support (Exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest) Home assisted ventilation (via tracheotomy or noninvasive) except for CPAP/BIPAP used only for sleep-disordered breathing Current active kidney stone Known history of oxalate kidney stones or history of oxalate nephropathy Kidney transplant recipient Use of home oxygen for chronic cardiopulmonary disease Moribund patient not expected to survive 24 hours Underlying malignancy or other condition with estimated life expectancy of less than 1 month Pregnant woman, woman of childbearing potential without a documented negative urine or serum pregnancy test during the current hospitalization, or woman who is breast feeding Prisoner Enrollment in another critical care based pharmacologic interventional trial Treating team unwilling to enroll because of intended use of Acetaminophen or Vitamin C

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sepsis<br>Patients admitted to the ICU with sepsis will be enrolled and monitored at time sequential time points during their treatment | Device: Capillary Refill Assessment<br>* Device to quantify capillary refill time<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood lactate Level | Correlation of Capillary refill to blood lactate | during procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vasoactive | Correlation of capillary refill to need for vasoactive medications | 24 hours | 
| 28 day hospital mortality | Correlation of initial capillary refill time to 28 day hospital mortality | 28 days |