The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients: the Simple Intensive Care Studies-I

SICS Study Grp, Hiemstra, B., Koster, G., Wiersema, R., Hummel, Y. M., van der Harst, P., Snieder, H., Eck, R. J., Kaufmann, T., Scheeren, T. W. L., Perner, A., Wetterslev, J., de Smet, A. M. G. A., Keus, F. & van der Horst, I. C. C., Feb-2019, In : Intensive Care Medicine. 45, 2, p. 190-200 11 p.

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PurposeClinical 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.MethodsIn this prospective, single-centre cohort study, we included all acutely ill patients admitted to the ICU and expected to stay>24h. 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 (4.5s, or skin mottling over the knee.ConclusionsSeven 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.

Original languageEnglish
Pages (from-to)190-200
Number of pages11
JournalIntensive Care Medicine
Issue number2
Publication statusPublished - Feb-2019


  • Physical examination, Cardiac index, Haemodynamics, Sensitivity and specificity, Ultrasonography, Critical care, Intensive care unit, Prospective study, PULMONARY-ARTERY CATHETERIZATION, OUTPUT, PHYSICIANS, ECHOCARDIOGRAPHY, ASSOCIATION, TEMPERATURE, SOCIETY, ADULTS, TOE

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