Vasopressor Support, Mean Arterial Pressure and Capillary Refill Time in Critically Ill Patients

Study Overview
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Brief Summary
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The goal of this observational study is to learn whether different doses of various vasopressor drugs influence capillary refill time (CRT) value in crtically ill patients. The main questions it aims to answer are: How do vasopressor drugs determine CRT value How does mean arterial pressure (MAP) determine CRT value How often CRT value is normal (< 3 sec) despite hypotensive MAP (<65 mmHg) Participants will have the CRT measured over the course of the ICU hospitalization. At the end of the study, multiple linear regression will be performed to verify whether different doses of vasopressor drugs influence CRT value.

Detailed Description
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The goal of this observational study is to learn whether different doses of various vasopressor drugs influence capillary refill time (CRT) value in critically ill patients. The main questions it aims to answer are: How does norepinephrine dose influence CRT value How does epinephrine dose influence CRT value How does argipressin dose influence CRT value How does dobutamine dose influence CRT value How does mean arterial pressure (MAP) determine CRT value How often CRT value is normal (< 3 sec) despite hypotensive MAP (<65 mmHg) Participants will have the CRT measured over the course of the ICU hospitalization. At the end of the study, multiple linear regression will be performed to verify whether different doses of vasopressor drugs influence CRT value. CRT will be a dependent variable. Independent variables will be as follows: age, MAP, norepinephrine dose, epinephrine dose, argipressin dose, dobutamine dose. CRT measurements will be performed in a standarized rigor (light, chronometer, pressure and ambient temperature will be the same in all patients)

Official Title
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Influence of Vasopressor Support and Mean Arterial Pressure on Capillary Refill Time Values in Critically Ill Patients: Prospective, Observational Study

Conditions
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Critical Illness

Intervention / Treatment
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* Diagnostic Test: Capillary refill time


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: critical illness requiring vasopressor support invasive blood pressure monitoring Exclusion Criteria: finger distal phalanx not available patient in a room of suboptimal ambient temperature

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study group<br>Critically ill patients undergoing any vasopressor treatment. CRT will be measured over the course of hospitalization. Maximal number of CRT measurements from a single patient is limited to 5. | Diagnostic Test: Capillary refill time<br>* CRT will be measured by applying firm pressure to the ventral surface of the index finger distal phalanx with a glass microscope slide. The pressure will be increased until the skin is blank and then maintained for 10 seconds. The time for return of the normal skin color will be registered with a chronometer, and > 3 seconds is defined as abnormal. Light and ambient temperature will be the same for all individuals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of norepinephrine dose on CRT value | In a multiple linear regression, it will be verified whether different doses of norepinephrine determine CRT value. | Through study completion, an average of 1 year | 
| Effect of mean arterial pressure on CRT value | In a multiple linear regression, it will be verified whether different values of MAP determine CRT value. | Through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of epinephrine dose on CRT value | In a multiple linear regression, it will be verified whether different doses of epinephrine determine CRT value. | Through study completion, an average of 1 year | 
| Effect of argipressin dose on CRT value | In a multiple linear regression, it will be verified whether different doses of argipressin determine CRT value. | Through study completion, an average of 1 year | 
| Effect of dobutamine dose on CRT value | In a multiple linear regression, it will be verified whether different doses of dobutamine determine CRT value. | Through study completion, an average of 1 year | 
| CRT value in MAP <65 mmHg | It will be analyzed whether in hypotensive conditions (MAP <65 mmHg), CRT values are normal (< 3 sec) | Through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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capillary refill time, norepinephrine, epinephrine, argipressin, dobutamine, mean arterial pressure