Usefulness of Capillary Refill Time and Skin Mottling Score to Predict Intensive Care Unit Admission

NCT ID: NCT03831022

Last Updated: 2019-02-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

1500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-12-17

Study Completion Date

2020-12-17

Brief Summary

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In the emergency department (ED), the severity assessment of shock is a fundamental step prior to the admission in intensive care unit (ICU). As biomarkers are time consuming to evaluate severity of the micro and macro-circulation alteration, capillary refill time and skin mottling score are 2 simples, available clinical criteria validated to predict mortality in the ICU.

The aim of this 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.

Detailed Description

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This trial is an observational, non-randomized controlled study. A total of 1500 patients admitted to the ED for a septic or hemorrhagic shock will be followed.

The primary outcome is the admission to the ICU.

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 during their hospital stay in order to precise their destination after ED (home, ICU, ward) and 28- and 90-days mortality after hospital admission.

Conditions

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Shock, Septic Shock, Hemorrhagic

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Capillary refill time and skin mottling score measurement at the admission to the emergency department

Patients who meet the inclusion criteria and none of the non-inclusion criteria will benefit from capillary refill time and skin mottling score measurement at the admission to the emergency department (ED) and followed during their hospital stay to precise the destination after ED (home, ICU, ward) and 30- and 90-days mortality after hospital admission.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Age \> 18 years
2. Skin mottling score\> 2 and/or capillary refill time \> 3secondes associated with at least one of the followings measured at the ED admission by the nurse in charge of the patient:

1. Systolic blood pressure \< 90mmHg or blood pressure decrease of 30% at least for patients with high blood pressure history
2. Heart rate \> 120 beats per minute
3. Respiratory rate \> 22 movements per minute
4. Glasgow coma scale \< 13.

Exclusion Criteria

1. Age \< 18 years
2. Pregnancy
3. Serious co morbid conditions with a not to be reanimated status known at the ED admission
4. Patients with guardianship or curator
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hôpital Cochin

OTHER

Sponsor Role collaborator

University Grenoble Alps

OTHER

Sponsor Role collaborator

University Hospital, Strasbourg, France

OTHER

Sponsor Role collaborator

Poitiers University Hospital

OTHER

Sponsor Role collaborator

Begin Military Hospital

UNKNOWN

Sponsor Role collaborator

Argenteuil Hospital

UNKNOWN

Sponsor Role collaborator

University Hospital, Limoges

OTHER

Sponsor Role collaborator

University Hospital, Marseille

OTHER

Sponsor Role collaborator

Hôpital Necker-Enfants Malades

OTHER

Sponsor Role lead

Responsible Party

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Romain Jouffroy

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Necker enfants malades Hospital

Paris, Île-de-France Region, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Romain Jouffroy, MD

Role: CONTACT

+33144495989

Benoit Vivien, MD, PhD

Role: CONTACT

+33144492424

Facility Contacts

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Romain Jouffroy, MD

Role: primary

+33144495989

Benoit Vivien, MD, PhD

Role: backup

+33144492424

References

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Pottecher T, Calvat S, Dupont H, Durand-Gasselin J, Gerbeaux P; SFAR/SRLF workgroup. Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France. Crit Care. 2006;10(4):311. doi: 10.1186/cc4965.

Reference Type BACKGROUND
PMID: 16941754 (View on PubMed)

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996 Jul;22(7):707-10. doi: 10.1007/BF01709751. No abstract available.

Reference Type BACKGROUND
PMID: 8844239 (View on PubMed)

Pickard A, Karlen W, Ansermino JM. Capillary refill time: is it still a useful clinical sign? Anesth Analg. 2011 Jul;113(1):120-3. doi: 10.1213/ANE.0b013e31821569f9. Epub 2011 Apr 25.

Reference Type BACKGROUND
PMID: 21519051 (View on PubMed)

Ait-Oufella H, Bige N, Boelle PY, Pichereau C, Alves M, Bertinchamp R, Baudel JL, Galbois A, Maury E, Guidet B. Capillary refill time exploration during septic shock. Intensive Care Med. 2014 Jul;40(7):958-64. doi: 10.1007/s00134-014-3326-4. Epub 2014 May 9.

Reference Type BACKGROUND
PMID: 24811942 (View on PubMed)

Ait-Oufella H, Lemoinne S, Boelle PY, Galbois A, Baudel JL, Lemant J, Joffre J, Margetis D, Guidet B, Maury E, Offenstadt G. Mottling score predicts survival in septic shock. Intensive Care Med. 2011 May;37(5):801-7. doi: 10.1007/s00134-011-2163-y. Epub 2011 Mar 4.

Reference Type BACKGROUND
PMID: 21373821 (View on PubMed)

Lima A, Jansen TC, van Bommel J, Ince C, Bakker J. The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients. Crit Care Med. 2009 Mar;37(3):934-8. doi: 10.1097/CCM.0b013e31819869db.

Reference Type BACKGROUND
PMID: 19237899 (View on PubMed)

Lara B, Enberg L, Ortega M, Leon P, Kripper C, Aguilera P, Kattan E, Castro R, Bakker J, Hernandez G. Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality. PLoS One. 2017 Nov 27;12(11):e0188548. doi: 10.1371/journal.pone.0188548. eCollection 2017.

Reference Type BACKGROUND
PMID: 29176794 (View on PubMed)

Mrgan M, Rytter D, Brabrand M. Capillary refill time is a predictor of short-term mortality for adult patients admitted to a medical department: an observational cohort study. Emerg Med J. 2014 Dec;31(12):954-8. doi: 10.1136/emermed-2013-202925. Epub 2013 Sep 17.

Reference Type BACKGROUND
PMID: 24045049 (View on PubMed)

Jouffroy R, Saade A, Tourtier JP, Gueye P, Bloch-Laine E, Ecollan P, Carli P, Vivien B. Skin mottling score and capillary refill time to assess mortality of septic shock since pre-hospital setting. Am J Emerg Med. 2019 Apr;37(4):664-671. doi: 10.1016/j.ajem.2018.07.010. Epub 2018 Jul 6.

Reference Type BACKGROUND
PMID: 30001815 (View on PubMed)

Other Identifiers

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2018-A02588-47

Identifier Type: -

Identifier Source: org_study_id

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