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The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients

the Simple Intensive Care Studies-I

The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients

the Simple Intensive Care Studies-I

Samenvatting

PURPOSE: Clinical examination is often the first step to diagnose shock and estimate cardiac index. In the Simple Intensive Care Studies-I, we assessed the association and diagnostic performance of clinical signs for estimation of cardiac index in critically ill patients. METHODS: In this prospective, single-centre cohort study, we included all acutely ill patients admitted to the ICU and expected to stay > 24 h. We conducted a protocolised clinical examination of 19 clinical signs followed by critical care ultrasonography for cardiac index measurement. Clinical signs were associated with cardiac index and a low cardiac index ( 4.5 s, or skin mottling over the knee. CONCLUSIONS: Seven out of 19 clinical examination findings were independently associated with cardiac index. For estimation of cardiac index, clinical examination was found to be insufficient in multivariable analyses and in diagnostic accuracy tests. Additional measurements such as critical care ultrasonography remain necessary.

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OrganisatieHanze
Gepubliceerd inIntensive Care Medicine Springer Verlag, Vol. 45, Uitgave: 2, Pagina's: 190-200
Datum2019-02-27
TypeArtikel
DOI10.1007/s00134-019-05527-y
TaalEngels

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