可穿戴式毛细血管再充盈时间测量装置的可行性研究

Pub Date : 2024-02-20 DOI:10.1007/s10015-024-00936-9
Masayoshi Shinozaki, Daiki Saito, Taka-aki Nakada, Yukihiro Nomura, Toshiya Nakaguchi
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引用次数: 0

摘要

毛细血管再充盈时间(CRT)是国际公认的外周循环指标。测量毛细血管再充盈时间的方法是在指甲上按压几秒钟,然后松开,观察血液在指尖再充盈的过程。2021 年脓毒症和脓毒性休克治疗国际指南中又增加了一项新建议,即测量 CRT 以确定脓毒性休克成人患者的末梢循环状态。然而,目前的 CRT 测量方法缺乏客观性。之前的研究报道了测量设备和视频分析系统的开发情况,这些设备和系统涉及复杂的测量环境构建,并假定只能进行院内测量。此外,由于医务工作者携带医疗设备的数量有限,因此需要能在一次测量中获得多个生物特征指标的设备。因此,本研究开发了一种可穿戴式 CRT 测量设备原型,并通过比较与过去开发的 CRT 测量设备的一致性、类内相关系数和变异系数来评估其可行性。结果表明,不同测量方法的平均 CRT 值是一致的,评分者内部的可靠性为中等或较好,变异系数无差异。因此,这些结果表明了所建议的可穿戴式 CRT 设备的可行性。
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Feasibility study of wearable capillary refill time measurement device

Capillary refill time (CRT) is an internationally accepted indicator of peripheral circulation. The CRT is measured by applying compression to the fingernail for a few seconds, releasing it, and observing the process of refilling of blood at the fingertip. The international guidelines for the management of sepsis and septic shock 2021 contains an additional new recommendation for CRT measurement to determine the peripheral circulation statuses of adult patients with septic shock. However, the current CRT measurement method lacks objectivity. Previous studies have reported the development of measurement devices and video analysis systems, which involve complex measurement environment construction and assume only in-hospital measurements. In addition, since medical workers are limited in the number of carrying medical devices, devices that can be used to obtain multiple biometric indicators in a single measurement are needed. Hence, a prototype wearable CRT measurement device was developed in this study, and its feasibility was evaluated by comparing the agreement, intra-class correlation coefficient, and coefficient of variation with those of a CRT measurement device developed in the past. The results indicated that mean CRTs between measurement methods were agreement, with moderate or better intra-rater reliability and no difference in coefficient of variation. Therefore, the results indicate the feasibility of the proposed wearable CRT device.

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