title: Changes in peripheral perfusion relate to visceral organ perfusion in early septic shock: A pilot study.
abstract: To correlate clinical indicators of peripheral perfusion with visceral organ vascular tone in 30 septic shock patients.
  
  
  
  In a prospective pilot study, capillary refill time, the Mottling score, and peripheral temperature were determined within 24, 48, and 72 hours after intensive care unit admission. Simultaneously, pulsatility indices in the liver, spleen, kidneys, and intestines were measured by Doppler ultrasonography. Correlation analyses were calculated, applying an adjusted significance level (P< .0125) to correct for multiple testing.
  
  
  
  Significant relationships were observed between the pulsatility index of selected organs and the capillary refill time (intestines: r= 0.325, P= .007), and the Mottling score (kidneys: r= 0.396, P= .006), but not peripheral temperature (all r< 0.14, P> .05). An association over time was observed for the capillary refill time and pulsatility index of the liver (P= .04) and intestines (P= .03) as well as for the Mottling score and the kidneys' pulsatility index (P= .03), but not for peripheral temperature and any visceral organs' pulsatility index.
  
  
  
  Capillary refill time and skin mottling may be correlated with the pulsatility index, a sonographic surrogate of vascular tone, of visceral organs in early septic shock.
authors.affiliation: Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Brunauer
authors.affiliation: Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Koköfer
authors.affiliation: Department of Emergency and Critical Care Medicine, Central State University Hospital, Ulaanbaatar, Mongolia.
authors.forename: Otgon
authors.initials: O
authors.lastname: Bataar
authors.affiliation: Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria.
authors.forename: Ilse
authors.initials: I
authors.lastname: Gradwohl-Matis
authors.affiliation: Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dankl
authors.affiliation: Department of Intensive Care Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Medical Center, New York, NY; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de, Chile, Santiago.
authors.forename: Jan
authors.initials: J
authors.lastname: Bakker
authors.affiliation: Department of Anesthesiology, Perioperative and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Medical University, Salzburg, Austria. Electronic address: M.Duenser@salk.at.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Dünser
mesh_terms: D001831:Body Temperature; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007422:Intestines / Q000098:blood supply; D007668:Kidney / Q000098:blood supply; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000098:blood supply; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow; D012772:Shock, Septic / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging; D013154:Spleen / Q000098:blood supply; D016896:Treatment Outcome
keywords: Capillary refill time; Peripheral perfusion; Pulsatility index; Septic shock; Skin mottling; Visceral vascular tone