The objective of this study is to identify the types of Photoplethysmographic waves present in adults with septic shock and determine whether these waves correlate with other variables of tissue hypoperfusion such as capillary refil, serum lactate and mottling score.
Photoplethysmography is the technology used in pulse oximeters in order to calculate arterial oxygen saturation and pulse rate, this technology generates a wave whose morphology has been related to blood flow and arterial tone. Recently Tusman and collaborators described a morphological classification of the photoplethysmografic wave that has a high correlation with arterial tone, such classification is divided in 6 types; Types I and II indicate vasoconstriction, Type III normal arterial tone and Types IV, V and VI describe mild, medium and severe vasodilation respectively, therefore it could be used to identify the arterial tone in those patients with septic shock. This study will identify the type of photoplethysmographic waves that are present in adults with septic shock based in the Tusman and collaborators classification, it will also describe the frequency of appearance and their correlation with other hemodynamic variables such as capillary refill, serum lactate, mottling score, heart rate, mean arterial pressure, pulse pressure and perfusion index.
Study Type
OBSERVATIONAL
Enrollment
116
Hospital General de México Dr. Eduardo Liceaga
Mexico City, Cuauhtemoc, Mexico
RECRUITINGPhotoplethysmography wave types in adult patiens with septic shock
The type of Photoplethysmography wave obtained and digitized through the sensor of a conventional pulse oximeter without autoscale. The wave will be classified in type I, II, III, IV, V and VI according to the criteria proposed by Tusman and collaborators
Time frame: After the inclusion of the patient.
Capillary refill
Mesurement of the time it takes for the ventral surface of the fingers to return to its normal color after being compressed by a transparent microscope slide for 10 seconds. Measured in seconds.
Time frame: After the inclusion of the patient
Mottling score
Classification regarding the type of mottling surrounding the knee in each patient. The classification is as folllows 0= no mottling, 1= Mottling the size of a coin on the knee, 2= mottling extending just over the superior part of the knee, 3= Mottling covering up to half the thigh, 4= mottling continues to the inguinal fold, 5= severe mottling extending beyond the inguinal area.
Time frame: After the inclusion of the patient
Serum lactate levels
Mesurement of serum lactate through venous blood gass analysis at hospital admittanace. Mesured in mmol/L
Time frame: After the inclusion of the patient
Heart rate
Determination of the number of heart beats per minute in patients obtenined with telemetry. Messured in beats per minute
Time frame: After the inclusion of the patient
Sistolic and diastolic blood pressure
Messurement of arterial blood pressure with an adult sized aneroid sphygmomanometer. Messurement in mmHg.
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Time frame: After the inclusion of the patient
Perfussion index
Messurement of the perfusion index obtained and calculated by a sensor in a conventional pulse oximeter without autoscale. Measurement in whole numbers.
Time frame: After the inclusion of the patien