ReviewCurrent opinion in critical care2017
Clinical examination for diagnosing circulatory shock.
Review in Current opinion in critical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed.
- HIMAP POCUS protocol for early evaluation of undifferentiated shocked patients at the emergency department: A prospective study of diagnostic accuracy and time efficiency.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Cardiogenic Shock Systems of Care Best Practices. Part 1: Prehospital and Emergency Department Evaluation and Management.US cardiology · 2026Review
- Point-of-care ultrasound: Uniting cardiology and nephrology at the bedside.World journal of cardiology · 2025Review
- The Predictive Value of Clinical Signs to Identify Shock in Critically Ill Patients.Diagnostics (Basel, Switzerland) · 2025Article
- Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit.Journal of clinical medicine · 2024Review
- Autonomic dysfunction as a predictor of infection in neurocritical care unit: a prospective cohort study.Journal of clinical monitoring and computing · 2024Article
- Diagnostic Adjunct Techniques in the Assessment of Hypovolemia: A Prospective Pilot Project.The Journal of surgical research · 2024Article
- Carotid Flow Time Compared with Invasive Monitoring as a Predictor of Volume Responsiveness in ICU patients.POCUS journal · 2023Article
- Pathophysiology of fluid administration in critically ill patients.Intensive care medicine experimental · 2022Review
- Critical Care Echocardiography: A Primer for the Nephrologist.Advances in chronic kidney disease · 2021Review
- It's Not All about Echocardiography. Open the Lung Window for the Cardiac Emergencies.Medicina (Kaunas, Lithuania) · 2021Review
- Article
- Fluid administration for acute circulatory dysfunction using basic monitoring.Annals of translational medicine · 2020Review
- Continuous cardiac output assessment or serial echocardiography during septic shock resuscitation?Annals of translational medicine · 2020Review
- Clinical examination findings as predictors of acute kidney injury in critically ill patients.Acta anaesthesiologica Scandinavica · 2020Observational
- A Bayesian Network Analysis of the Diagnostic Process and Its Accuracy to Determine How Clinicians Estimate Cardiac Function in Critically Ill Patients: Prospective Observational Cohort Study.JMIR medical informatics · 2019Article
- Clinical Examination for the Prediction of Mortality in the Critically Ill: The Simple Intensive Care Studies-I.Critical care medicine · 2019Article
- One approach to circulation and blood flow in the critical care unit.World journal of critical care medicine · 2019Review
- The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients: the Simple Intensive Care Studies-I.Intensive care medicine · 2019Observational
- Current use of vasopressors in septic shock.Annals of intensive care · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose of reviewIn the acute setting of circulatory shock, physicians largely depend on clinical examination and basic laboratory values. The daily use of clinical examination for diagnostic purposes contrasts sharp with the limited number of studies. We aim to provide an overview of the diagnostic accuracy of clinical examination in estimating circulatory shock reflected by an inadequate cardiac output (CO). RECENT
findingsRecent studies showed poor correlations between CO and mottling, capillary refill time or central-to-peripheral temperature gradients in univariable analyses. The accuracy of physicians to perform an educated guess of CO based on clinical examination lies around 50% and the accuracy for recognizing a low CO is similar. Studies that used predefined clinical profiles composed of several clinical examination signs show more reliable estimations of CO with accuracies ranging from 81 up to 100%. SUMMARY: Single variables obtained by clinical examination should not be used when estimating CO. Physician's educated guesses of CO based on unstructured clinical examination are like the 'flip of a coin'. Structured clinical examination based on combined clinical signs shows the best accuracy. Future studies should focus on using a combination of signs in an unselected population, eventually to educate physicians in estimating CO by using predefined clinical profiles.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.