ArticleFrontiers in medicine2026
Critical care ultrasound evaluation of snuffbox artery vascular tension: a prospective observational study between healthy volunteers and intensive care unit patients.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Systemic vascular resistance is conventionally assessed using invasive methods; the snuffbox artery resistance index (RI) is a superior non-invasive predictor of lactate clearance in septic shock patients to the perfusion index. However, the normal reference ranges of the snuffbox artery RI and pulsatility index (PI) remain undefined, with inconsistent RI data in healthy populations due to non-standardized measurements. Objective: This study aimed to establish the normal reference ranges for the snuffbox artery RI and PI in healthy volunteers and to compare these hemodynamic parameters between healthy volunteers and intensive care unit (ICU) patients to evaluate their clinical utility in assessing peripheral microcirculation. Design: This was a single-center prospective observational cohort study. Setting: This study was conducted at a 4,900-bed tertiary care hospital with a 215-bed closed ICU in China. Participants: A total of 91 healthy volunteers-stratified by history of hypertension and age-and 55 ICU patients-classified by shock status-were included in the study from February to November 2024. Interventions: No interventional measures were implemented; all data were collected through a non-invasive ultrasound and clinical record review. Measurements and main results: Ultrasound parameters and vital signs were measured under standardized conditions. The normal RI and PI ranges in healthy volunteers were 0.72-0.75 and 1.93-2.03, respectively. Significant differences in the RI and end-diastolic flow velocity (EDV) were found between healthy volunteers and ICU patients (all Conclusion: This study established standardized normal reference ranges for the snuffbox artery RI and PI in healthy adults and found significant RI and EDV differences between ICU patients and healthy volunteers. EDV may serve as a potential prognostic indicator, and alterations in diastolic flow may reflect early peripheral vascular tension changes. The lack of parameter differences between shock and non-shock ICU patients reveals the physiological limitations of the snuffbox artery RI as a surrogate for systemic vascular resistance.
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