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 - TRCMARBSAU study [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-28459

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 - TRCMARBSAU study

Jouffroy Romain1, Emmanuel Bloch-laine2, Maxime Maignan3, Pierrick Le Borgne4, Nicolas Marjanovic5, Thomas Lafon6, Scarlett Dehdar7, Lea Thomas8, Pierre Michelet9, Benoit Vivien1
1Intensive Care Unit, Anaesthesiology, SAMU, Necker Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
2Emergency department, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
3Emergency department and SAMU, Grenoble Alps University Hospital, Grenoble, France 7 Emergency Department, Hautepierre Hospital, University Hospital of Strasbourg, France
4INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative NanoMedicine (RNM), Fédération de Médecine Translationnelle (FMTS), University of Strasbourg, France
5Emergency department and SAMU, Poitiers University Hospital, Poitiers, France
6Emergency Department, SAMU, Inserm CIC 1435, Limoges University Hospital Center France
7Emergency department, Argenteuil Hospital, Argenteuil, France
8Emergency department, Begin Military Hospital, Clamart, France
9Emergency Department, Timone Hospital, Aix-Marseille University – CV2N, INSERM, INRA, Assistance Publique Hôpitaux de Marseille, Marseille, France

Introduction
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 two simple, 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.
Methods/Design
This trial is an observational, non-randomized controlled study. A total of 1500 patients admitted to the ED for a septic or haemorrhagic shock will be followed.
The primary outcome is the admission to the ICU.
Intervention
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.
Discussion
The results from this 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. This study aims to provide two simple, reliable and non-invasive tools for the triage and early orientation of these patients.

Keywords: Capillary refill time, skin mottling score, emergency, intensive care unit, prediction




Corresponding Author: Jouffroy Romain, France


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