Contribution of Capillary Refilling Time and Skin Mottling Score to Predict ICU Admission of Patients with Septic or haemorrhagic Shock Admitted to the Emergency Department: A TRCMARBSAU Study
2019
Jouffroy, Romain | Bloch-Laine, Emmanuel | Maignan, Maxime | Borgne, Pierrick Le | Marjanovic, Nicolas | Lafon, Thomas | Dehdar, Scarlett | Thomas, Lea | Michelet, Pierre | Vivien, Benoit | Service d'Anesthésie Réanimation [CHU Necker] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Necker - Enfants Malades [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP) | Centre Hospitalier Universitaire [CHU Grenoble] (CHUGA) | Nanomédecine Régénérative (NanoRegMed) ; Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Centre hospitalier universitaire de Poitiers = Poitiers University Hospital (CHU de Poitiers [La Milétrie]) | Centre d'Investigation Clinique de Limoges (CIC1435) ; CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM) | Centre hospitalier Victor Dupouy [Centre hospitalier d'Argenteuil] (CH Argenteuil) | Hôpital d'instruction des Armées Percy ; Service de Santé des Armées | Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN) ; Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Show more [+] Less [-]English. Objective: In the emergency department (ED), the severity assessment of shock is a fundamental step prior to the admission in the intensive care unit (ICU). As biomarkers are time consuming to evaluate the severity of micro- and macro-circulation alteration, capillary refill time and skin mottling score are two simple, available clinical criteria validated to predict mortality in the ICU. The aim of the present study is to provide clinical evidence that capillary refill time and skin mottling score assessed in the ED also predict ICU admission of patients with septic or haemorrhagic shock.Methods: This trial is an observational, non-randomised controlled study. A total of 1500 patients admitted to the ED for septic or haemorrhagic shock will be enrolled into the study. The primary outcome is the admission to the ICU.Results: The study will not impact the treatments provided to each patient. Capillary refill time and skin mottling score will not be taken into account to decide patient's treatments and/or ICU admission. Patients will be followed up during their hospital stay to determine their precise destination after the ED (home, ICU or ward) and the 28- and 90-day mortality after hospital admission.Conclusion: The results from the present study will provide clinical evidence on the correlation between the ICU admission and the capillary refill time and the skin mottling score in septic or haemorrhagic shock admitted to the ED. The aim of the present study is to provide two simple, reliable and non-invasive tools for the triage and early orientation of these patients.
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