A comparative Study between the Effect of Resuscitation Strategy targeting Capillary Refill Time And Lactate Level To predict Mortality Among Patients With Septic Shock

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Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Septic shock is diagnosed when an individual has sepsis hypotension despite adequate fluid resuscitation and hypoperfusion and requires vasopressor medication to maintain a mean arterial pressure (MAP) of 65 mm Hg or higher. Aim of the work: To assess early tissue hypoperfusion in adult individuals with septic shock by contrasting lactate level-targeted resuscitation with peripheral perfusion-targeted resuscitation by capillary refill time (CRT). Patients and methods: A comparative prospective research was performed at Al-Azhar University Hospitals from January 2023 to July 2023. The researchers also acquired permission from the Ethical Committee of the Faculty of Medicine, as well as approval from the Institutional Review Board (IRB). This research comprised 52 intensive care unit (ICU) individuals with a diagnosis of septic shock. Results: The present study findings indicate that regarding age, sex, BMI, comorbidities, HR, causes of septic shock, serum lactate and CRT, duration of mechanical ventilation, ICU stay, and hospitalization, there was no significant variation among the two groups. Between Group B and Group A, there was not a significant distinction in the occurrence of multiorgan failure or mortality. Conclusion: The present study showed that the two methods, CRT and lactate level, are accurate and well used in predicting early tissue hypoperfusion among septic shock patients. Multiorgan failure and 28-day mortality were slightly more prevalent in Group A (who had capillary refill time measurements), whereas Group B (who underwent lactate level measurements) was not statistically significant.

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