PREDICT (Perfusion Restriction Evaluation with Doppler Indices, Cardiac output and Thermography): A study of Point of Care arterial doppler indices, Microcirculatory and Macro circulatory parameters and their association with clinical outcomes in patients with sepsis presenting to the Emergency Medicine department.

One of the leading causes of preventable deaths, especially in low- and middle- income countries is sepsis. Hence, early intervention in treating patients presenting to the Emergency Department with sepsis is crucial in improving patient outcomes. Traditionally, patients’ macro circulatory parameters such as mean arterial pressure (MAP) and heart rate are considered, which may not always reflect tissue perfusion. Patients can have normal blood pressure but may still be experiencing ongoing microcirculatory failure – cryptic shock.

Recent studies indicate that microcirculatory dysfunction, indicated by impaired capillary refill time, high lactate levels, or changes in doppler indices, may precede hemodynamic failure and organ damage. Despite this, microcirculatory parameters are not commonly utilised in the emergency settings because of easily implementable technology, absence of standardised methods and lack of awareness. This study fills a significant gap by combining point-of-care ultrasound evaluations of microcirculation and overall circulation in the Emergency Department (ED), while linking them to clinical outcomes after 24 hours, 72 hours, and one week. These outcomes include the need for increased vasopressors, renal replacement therapy, and mortality rates. By establishing correlations and identifying the gaps, this research could improve predictions for sepsis and guide evidence-based triage decisions in EDs across the country.