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Capillary refill time

John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
Susannah Fleming, Peter J Gill, Ann Van den Bruel, Matthew Thompson
No abstract text is available yet for this article.
November 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
Jeongeun Ryu, Bae Geun Hwang, Sang Joon Lee
BACKGROUND AND AIMS: The refilling of embolized xylem vessels under tension is a major issue in water transport among vascular plants. However, xylem embolism and refilling remain poorly understood because of technical limitations. Direct observation of embolism repair in intact plants is essential to understand the biophysical aspects of water refilling in embolized xylem vessels. This paper reports on details of the water refilling process in leaves of the intact herbaceous monocot plant Zea mays and its refilling kinetics obtained by a direct visualization technique...
August 18, 2016: Annals of Botany
Ville Pettilä, Tobias Merz, Erika Wilkman, Anders Perner, Sari Karlsson, Theis Lange, Johanna Hästbacka, Peter Buhl Hjortrup, Anne Kuitunen, Stephan M Jakob, Jukka Takala
BACKGROUND: Septic shock has a 90-day mortality risk of up to 50 %. The hemodynamic targets, including mean arterial pressure (MAP) are not based on robust clinical data. Both severe hypotension and high doses of vasopressors may be harmful. Hence, re-evaluation of hemodynamic targets in septic shock is relevant. METHODS/DESIGN: The targeted tissue perfusion versus macrocirculation-guided standard care in patients with septic shock (TARTARE-2S) trial is a prospective, two-parallel-group, randomized, open-label, multicenter trial with assessor-blinded outcome evaluation...
2016: Trials
Adriana Gherardi da Ponte, Rafael Henrique Jácomo
INTRODUCTION: Febrile neutropenia is a major cause of morbidity and mortality in patients presenting this condition following chemotherapy against several malignancies. OBJECTIVE: To evaluate if capillary refill time (CRT) allows the prediction of poor clinical outcome with or without antibiotic dose escalation. METHOD: Capillary refill time was assessed in 50 patients with febrile neutropenia at its nadir after chemotherapy admitted to the emergency department at Hospital Universitário de Brasília...
July 2016: Revista da Associação Médica Brasileira
Simon Bourcier, Claire Pichereau, Pierre-Yves Boelle, Safaa Nemlaghi, Vincent Dubée, Gabriel Lejour, Jean-Luc Baudel, Arnaud Galbois, Jean-Rémi Lavillegrand, Naïke Bigé, Jalel Tahiri, Guillaume Leblanc, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella
BACKGROUND: Microcirculatory disorders leading to tissue hypoperfusion play a central role in the pathophysiology of organ failure in severe sepsis and septic shock. As microcirculatory disorders have been identified as strong predictive factors of unfavourable outcome, there is a need to develop accurate parameters at the bedside to evaluate tissue perfusion. We evaluated whether different body temperature gradients could relate to sepsis severity and could predict outcome in critically ill patients with severe sepsis and septic shock...
December 2016: Annals of Intensive Care
Evelien de Vos-Kerkhof, Tarik Krecinic, Yvonne Vergouwe, Henriëtte A Moll, Ruud G Nijman, Rianne Oostenbrink
OBJECTIVE: To determine the agreement between peripheral and central capillary refill time (pCRT/cCRT) and their diagnostic values for detecting serious bacterial infection (SBI) in febrile children attending the paediatric emergency department (ED). DESIGN: Prospective observational study. SETTING: Paediatric ED, Erasmus Medium Care-Sophia Children's hospital, the Netherlands. PATIENTS: 1193 consecutively included, previously healthy, febrile children (1 month-16 years) with both pCRT measurements and cCRT measurements available...
June 23, 2016: Archives of Disease in Childhood
Abu Sadat Mohammad Sayeem Bin Shahid, Tahmeed Ahmed, K M Shahunja, Senjuti Kabir, Fahmida Chowdhury, Abu Syeed Golam Faruque, Sumon Kumar Das, Mohammad Habibur Rahman Sarker, Pradip Kumar Bardhan, Mohammod Jobayer Chisti
BACKGROUND: Although Streptococcal bacteremia is common in diarrheal children with high morbidity and mortality, no systematic data are available on Streptococcal bacteremia in diarrheal children. We sought to evaluate the factors associated with Streptococcal bacteremia in diarrheal children under five years of age and their outcome. METHODS: We used an unmatched case-control design to investigate the associated factors with Streptococcal bacteremia in all the diarrheal children under five years of age through electronic medical record system of Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh...
2016: PloS One
Ferit Kulalı, Ebru Ergenekon, Selma Aktas, Ebru Kazancı, Sezin Unal, İbrahim Hirfanoğlu, Esra Önal, Canan Türkyılmaz, Esin Koç, Yıldız Atalay
BACKGROUND: Microcirculation is an important component of hemodynamic physiology . It can be assessed simply by clinical scores or by a variety of techniques including sidestream dark field (SDF) imaging and peripheral perfusion index (PI) measurements. Mode of delivery may have affects on microcirculation during transitional period. The aim of this study was to compare skin microcirculation in newborns born via vaginal delivery (VD) or cesarian section (C/S). METHODS: Term healthy newborns not requiring NICU admission were included...
April 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jatinder Gulani, Amory Koch, Mark G Chappell, Christine L Christensen, Paul Facemire, Vijay K Singh, Natalia I Ossetrova, Venkataraman Srinivasan, Rebecca K Holt
This case report describes a rhesus macaque (Macaca mulatta; male; age, 5 y; weight, 6.7 kg) with anorexia, dehydration, lethargy, ataxia, and generalized skin rashes that occurred 30 d after total-body irradiation at 6.5 Gy ((60)Co γ-rays). Physical examination revealed pale mucus membranes, a capillary refill time of 4 s, heart rate of 180 bpm. and respirations at 50 breaths per minute. Diffuse multifocal maculopapulovesicular rashes were present on the body, including mucocutaneous junctions. The CBC analysis revealed a Hct of 48%, RBC count of 6...
April 2016: Comparative Medicine
Huseyin Cihan, Zeki Yilmaz, Nilufer Aytug
The aim of this study was to evaluate the cardiac functions in healthy Eurasian brown bears (Ursus arctos arctos) living in a seminatural area during their active season. Twelve clinically healthy brown bears were selected based on their normal physical examination, hematologic, and serum biochemistry results. These bears were divided into two groups based on age; subadult (<5 yr, n = 4) and adult (≥5 yr, n = 8). After the chemical immobilization (ketamine and xylazine), routine clinical and laboratory examinations were performed...
March 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Andrea Lo Vecchio, Jorge Amil Dias, James A Berkley, Chris Boey, Mitchell B Cohen, Sylvia Cruchet, Ilaria Liguoro, Eduardo Salazar Lindo, Bhupinder Sandhu, Philip Sherman, Toshiaki Shimizu, Alfredo Guarino
OBJECTIVE: Acute gastroenteritis (AGE) is a major cause of child mortality and morbidity. This study aimed at systematically reviewing clinical practice guidelines (CPGs) on AGE to compare recommendations and provide the basis for developing single universal guidelines. METHODS: CPGs were identified by searching MEDLINE, Cochrane-Library, National Guideline Clearinghouse and Web sites of relevant societies/organizations producing and/or endorsing CPGs. RESULTS: The definition of AGE varies among the 15 CPGs identified...
August 2016: Journal of Pediatric Gastroenterology and Nutrition
Eduard Kieser, Kiran Dellimore, Cornie Scheffer, Cobus Visser, Johan Smith
Dehydration resulting from acute diarrhea is one of the leading causes of infant mortality in the developing world. Safe assessment of an infant's hydration level is essential to determine appropriate clinical intervention strategies. However, clinical hydration scales, which are the current gold standard for non-invasive hydration assessment, are often unreliable in lower resource settings. This study presents the development and testing of non-invasive, optical sensors for the objective assessment of dehydration based on the quantitative measurement of skin recoil time, capillary refill time and skin temperature...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
L L Blaxter, D E Morris, J A Crowe, C Henry, S Hill, D Sharkey, H Vyas, B R Hayes-Gill
Capillary refill time (CRT) is a simple means of cardiovascular assessment which is widely used in clinical care. Currently, CRT is measured through manual assessment of the time taken for skin tone to return to normal colour following blanching of the skin surface. There is evidence to suggest that manually assessed CRT is subject to bias from ambient light conditions, a lack of standardisation of both blanching time and manually applied pressure, subjectiveness of return to normal colour, and variability in the manual assessment of time...
January 2016: Physiological Measurement
Sandeep Arya, Paul Bauer, Yong Han
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Rosie Hague
Most illnesses associated with fever are self-limiting and children recover with no specific treatment. However, fever can also be the presenting feature of serious illness, which may be life threatening if not diagnosed and treated appropriately. It is important to establish whether the temperature has been measured and, if so, how. The height of the temperature should be recorded, and always enquire what device has been used, as a reading from a forehead thermometer may not be accurate. While many families will use a thermometer the impression of the child being hot to touch without formal measurement should still be taken seriously...
July 2015: Practitioner
M Ussat, C Vogtmann, C Gebauer, F Pulzer, U Thome, M Knüpfer
AIMS: The study investigated the association between clinical symptoms and late-onset sepsis (LOS) in preterm infants with the aim of identifying a non-invasive tool for the early detection of LOS. METHODS: This was a prospective study of 83 episodes of suspected LOS in 67 preterm infants. At the time LOS was suspected, we recorded a standardized set of clinical symptoms. A diagnosis of "clinical LOS" (Clin-LOS), "culture-proven LOS" (Prov-LOS) or "LOS not present" (No-LOS) was made on the basis of C-reactive protein (CrP) and blood culture results where Clin-LOS was defined as CrP>10mg/l, Prov-LOS was defined as CrP>10mg/l AND positive blood cultures, or it was established that there was no sepsis present (No-LOS)...
December 2015: Early Human Development
Laila Curtis, John Harold Burford, Jennifer Sara Marian Thomas, Marise Linda Curran, Tom Curtis Bayes, Gary Crane William England, Sarah Louise Freeman
BACKGROUND: The majority of research on the evaluation of horses with colic is focused on referral hospital populations. Early identification of critical cases is important to optimise outcome and welfare. The aim of this prospective study was to survey the primary evaluation of horses with clinical signs of abdominal pain by veterinary practitioners, and compare the initial presentation of critical and non-critical cases. RESULTS: Data from 1016 primary evaluations of horses presenting with clinical signs of colic were submitted by 167 veterinary practitioners across the United Kingdom over a 13 month period...
October 6, 2015: Acta Veterinaria Scandinavica
Susannah Fleming, Peter Gill, Caroline Jones, James A Taylor, Ann Van den Bruel, Carl Heneghan, Nia Roberts, Matthew Thompson
IMPORTANCE: Capillary refill time (CRT) is widely recommended as part of the routine assessment of unwell children. OBJECTIVE: To determine the diagnostic value of capillary refill time for a range of serious outcomes in children. METHODS: We searched Medline, Embase and CINAHL from inception to June 2014. We included studies that measured both capillary refill time and a relevant clinical outcome such as mortality, dehydration, meningitis, or other serious illnesses in children aged up to 18 years of age...
2015: PloS One
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