%0 Journal Article
%T A New Monitor to Measure Dermal Blood Flow in Critically Ill Patients: A Preliminary Study
%A Jonathan Cohen
%A Ilya Skoletsky
%A Rina Chen
%A Daniel Weiss
%A Pierre Singer
%J ISRN Critical Care
%D 2013
%R 10.5402/2013/578316
%X Background. Conditions of reduced perfusion are characterized by redistribution of blood flow away from the skin to more vital organs. Objectives. To assess the efficacy of a noninvasive, dermal blood flow (DBF) monitor in detecting changes in perfusion in critically ill patients. Methods. Eleven adult, critically ill patients in a general ICU were studied. DBF, finger plethysmography, and invasive mean arterial pressure (MAP) were recorded over an 8-hour period. DBF was measured using the DermaFlow DBF monitor via a skin probe placed on the anterior chest wall. Sensitivity was evaluated by visual inspection during active states, either induced, for example, fluid administration, or spontaneous, for example, altered hemodynamics, while specificity was evaluated during stable states. Data are expressed in terms of standard deviation of the difference (SDD) between the MAP and each of the tested methods. Results. The DBF detected all true changes detected by MAP while plethysmography detected fewer of these events. Based on SDD, the specificity of the DBF was found to be better than that of plethysmography and close in value to the MAP. Conclusions. This preliminary study suggests that the DBF monitor may be a useful noninvasive method for detecting changes in perfusion in critically ill patients. 1. Introduction Many conditions necessitating admission to an intensive care unit are characterized during their course by hypovolemia and decreased cardiac function. The result is decreased organ perfusion, which, if not corrected, may result in organ dysfunction and even death. Early recognition of these states is therefore essential for timely and appropriate intervention. The methods presently available for detecting such changes are typically invasive and/or expensive, including the measurement of intra-arterial blood pressure, cardiac output, and other hemodynamic variables and gastric tonometry. Conditions of reduced perfusion are characterized by redistribution of blood flow away from the skin and gastrointestinal tract to more vital organs, such as the heart and brain [1]. The skin therefore provides a potentially, readily accessible organ to detect changes in perfusion. We report on a preliminary study on the use of a novel noninvasive monitor, the dermal blood flow (DBF) monitor (DermaFlow, USA), for the detection of altered dermal blood flow and its comparison with another noninvasive monitor, namely, finger plethysmography derived from pulse oximetry, and with an invasive monitor, namely, mean intra-arterial blood pressure, in critically ill ICU
%U http://www.hindawi.com/journals/isrn.critical.care/2013/578316/