{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:28:31Z","timestamp":1791415711755,"version":"4.3.3"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Emergency Medicine"],"published-print":{"date-parts":[[2026,1]]},"DOI":"10.1016\/j.ajem.2025.09.024","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T22:53:07Z","timestamp":1758581587000},"page":"167-175","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"special_numbering":"C","title":["Peripheral Perfusion vs Standard Management in Sepsis\/Septic Shock: A Prospective Randomized ED Study"],"prefix":"10.1016","volume":"99","author":[{"given":"Y\u0131lmaz","family":"Ferhat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilmaz","family":"Serkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zturan \u0130brahim","family":"Ula\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u011fan Nurettin","family":"\u00d6zg\u00fcr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaka","family":"Elif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y\u0131lmaz K\u0131vrak","family":"Gamze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekdemir","family":"Murat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajem.2025.09.024_bb0005","doi-asserted-by":"crossref","unstructured":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 | Intensive Care Medicine. Accessed November 11, 2024. doi:10.1007\/s00134-021-06506-y","DOI":"10.1007\/s00134-021-06506-y"},{"issue":"8","key":"10.1016\/j.ajem.2025.09.024_bb0010","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The third international consensus definitions for Sepsis and septic shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"issue":"10219","key":"10.1016\/j.ajem.2025.09.024_bb0015","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: analysis for the global burden of disease study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"issue":"11","key":"10.1016\/j.ajem.2025.09.024_bb0020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0188548","article-title":"Capillary refill time during fluid resuscitation in patients with sepsis-related hyperlactatemia at the emergency department is related to mortality","volume":"12","author":"Lara","year":"2017","journal-title":"PLoS One"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0025","first-page":"H24","article-title":"Microcirculatory dysfunction in sepsis: pathophysiology, clinical monitoring, and potential therapies","volume":"311","author":"Miranda","year":"2016","journal-title":"Am. J. Phys. Heart Circ. Phys."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0030","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13613-019-0511-1","article-title":"Narrative review: clinical assessment of peripheral tissue perfusion in septic shock","volume":"9","author":"Hariri","year":"2019","journal-title":"Ann. Intensive Care"},{"issue":"1\u20132","key":"10.1016\/j.ajem.2025.09.024_bb0035","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1159\/000503775","article-title":"Microcirculation: physiology, pathophysiology, and clinical application","volume":"49","author":"Guven","year":"2020","journal-title":"Blood Purif."},{"issue":"7","key":"10.1016\/j.ajem.2025.09.024_bb0040","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1001\/jama.2019.0071","article-title":"Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels on 28-day mortality among patients with septic shock: the ANDROMEDA-SHOCK randomized clinical trial","volume":"321","author":"Hern\u00e1ndez","year":"2019","journal-title":"JAMA"},{"issue":"10","key":"10.1016\/j.ajem.2025.09.024_bb0045","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.4103\/0366-6999.231524","article-title":"Role of combining peripheral with sublingual perfusion on evaluating microcirculation and predicting prognosis in patients with septic shock","volume":"131","author":"Pan","year":"2018","journal-title":"Chin. Med. J."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0050","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1097\/CCM.0b013e3182742e8b","article-title":"Microcirculatory alterations in patients with severe Sepsis: impact of time of assessment and relationship with outcome*","volume":"41","author":"De Backer","year":"2013","journal-title":"Crit. Care Med."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0055","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/CCM.0b013e31819869db","article-title":"The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients","volume":"37","author":"Lima","year":"2009","journal-title":"Crit. Care Med."},{"issue":"12","key":"10.1016\/j.ajem.2025.09.024_bb0060","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s00134-014-3525-z","article-title":"Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine","volume":"40","author":"Cecconi","year":"2014","journal-title":"Intensive Care Med."},{"issue":"6","key":"10.1016\/j.ajem.2025.09.024_bb0065","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1097\/00003246-200206000-00006","article-title":"Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion","volume":"30","author":"Pinto Lima","year":"2002","journal-title":"Crit. Care Med."},{"issue":"10","key":"10.1016\/j.ajem.2025.09.024_bb0070","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1016\/j.ajem.2020.06.084","article-title":"Prognostic performance of peripheral perfusion index and shock index combined with ESI to predict hospital outcome","volume":"38","author":"Da\u015f","year":"2020","journal-title":"Am. J. Emerg. Med."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.024_bb0075","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/sim.6787","article-title":"Sample size considerations for the external validation of a multivariable prognostic model: a resampling study","volume":"35","author":"Collins","year":"2016","journal-title":"Stat. Med."},{"issue":"5","key":"10.1016\/j.ajem.2025.09.024_bb0080","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.jclinepi.2004.06.017","article-title":"Substantial effective sample sizes were required for external validation studies of predictive logistic regression models","volume":"58","author":"Vergouwe","year":"2005","journal-title":"J. Clin. Epidemiol."},{"issue":"7","key":"10.1016\/j.ajem.2025.09.024_bb0085","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1007\/s00134-014-3326-4","article-title":"Capillary refill time exploration during septic shock","volume":"40","author":"Ait-Oufella","year":"2014","journal-title":"Intensive Care Med."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0090","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/08850666211003507","article-title":"Prolonged capillary refilling as a predictor of mortality in patients with septic shock","volume":"37","author":"Morocho","year":"2022","journal-title":"J. Intensive Care Med."},{"key":"10.1016\/j.ajem.2025.09.024_bb0095","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1186\/s13054-016-1403-5","article-title":"The value of blood lactate kinetics in critically ill patients: a systematic review","volume":"20","author":"Vincent","year":"2016","journal-title":"Crit. Care"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0100","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1097\/SHK.0000000000000861","article-title":"Mortality is greater in septic patients with hyperlactatemia than with refractory hypotension","volume":"48","author":"Gotmaker","year":"2017","journal-title":"Shock"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0105","first-page":"280","article-title":"The holistic view on perfusion monitoring in septic shock","volume":"18","author":"Hernandez","year":"2012","journal-title":"Curr. Opin. Crit. Care"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0110","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s00134-018-5213-x","article-title":"The ten pitfalls of lactate clearance in sepsis","volume":"45","author":"Hernandez","year":"2019","journal-title":"Intensive Care Med."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0115","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00134-018-5415-2","article-title":"Fluid administration for acute circulatory dysfunction using basic monitoring: narrative review and expert panel recommendations from an ESICM task force","volume":"45","author":"Cecconi","year":"2019","journal-title":"Intensive Care Med."},{"issue":"11","key":"10.1016\/j.ajem.2025.09.024_bb0120","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1097\/CCM.0000000000003960","article-title":"Evaluation and predictors of fluid resuscitation in patients with severe Sepsis and septic shock","volume":"47","author":"Kuttab","year":"2019","journal-title":"Crit. Care Med."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0125","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s13054-015-0970-1","article-title":"A positive fluid balance is an independent prognostic factor in patients with sepsis","volume":"19","author":"Acheampong","year":"2015","journal-title":"Crit. Care"},{"issue":"2","key":"10.1016\/j.ajem.2025.09.024_bb0130","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ajem.2014.11.016","article-title":"Fluid balance in sepsis and septic shock as a determining factor of mortality","volume":"33","author":"Sirvent","year":"2015","journal-title":"Am. J. Emerg. Med."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0135","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1164\/rccm.201504-0781OC","article-title":"Assessment of global incidence and mortality of hospital-treated Sepsis. Current estimates and limitations","volume":"193","author":"Fleischmann","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0140","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/CCM.0000000000000611","article-title":"Incidence rate of community-acquired Sepsis among hospitalized acute medical patients\u2014A population-based survey*","volume":"43","author":"Henriksen","year":"2015","journal-title":"Crit. Care Med."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.024_bb0145","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s13054-018-2013-1","article-title":"Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study","volume":"22","author":"Baykara","year":"2018","journal-title":"Crit. Care"},{"issue":"2","key":"10.1016\/j.ajem.2025.09.024_bb0150","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/20009666.2018.1450592","article-title":"Predictors and outcome of invasive mechanical ventilation in hospitalized patients with sepsis: data from National Inpatient Sample","volume":"8","author":"Dhital","year":"2018","journal-title":"J. Community Hosp. Intern. Med. Perspect."},{"key":"10.1016\/j.ajem.2025.09.024_bb0155","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1186\/s13054-022-04029-6","article-title":"Early intubation and patient-centered outcomes in septic shock: a secondary analysis of a prospective multicenter study","volume":"26","author":"Mellado-Artigas","year":"2022","journal-title":"Crit. Care"},{"key":"10.1016\/j.ajem.2025.09.024_bb0160","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1186\/s12871-021-01471-x","article-title":"Outcome after intubation for septic shock with respiratory distress and hemodynamic compromise: an observational study","volume":"21","author":"Yang","year":"2021","journal-title":"BMC Anesthesiol."},{"key":"10.1016\/j.ajem.2025.09.024_bb0165","doi-asserted-by":"crossref","DOI":"10.1016\/j.mrgentox.2022.503516","article-title":"Lymphocyte DNA damage in sepsis and septic-shock intensive-care patients: damage is greater in non-intubated patients","volume":"879-880","author":"Karabacak","year":"2022","journal-title":"Mutat. Res. Genet. Toxicol. Environ. Mutagen."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0170","doi-asserted-by":"crossref","first-page":"R116","DOI":"10.1186\/cc12788","article-title":"The peripheral perfusion index and transcutaneous oxygen challenge test are predictive of mortality in septic patients after resuscitation","volume":"17","author":"He","year":"2013","journal-title":"Crit. Care"},{"key":"10.1016\/j.ajem.2025.09.024_bb0175","article-title":"Plethysmographic peripheral perfusion index: could it be a new vital sign?","volume":"8","author":"Elshal","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.024_bb0180","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.bja.2021.06.004","article-title":"Association of the intraoperative peripheral perfusion index with postoperative morbidity and mortality in acute surgical patients: a retrospective observational multicentre cohort study","volume":"127","author":"Agerskov","year":"2021","journal-title":"Br. J. Anaesth."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.024_bb0185","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s11739-020-02430-z","article-title":"Post-ROSC peripheral perfusion index discriminates 30-day survival after out-of-hospital cardiac arrest","volume":"16","author":"Savastano","year":"2021","journal-title":"Intern. Emerg. Med."},{"issue":"12","key":"10.1016\/j.ajem.2025.09.024_bb0190","doi-asserted-by":"crossref","first-page":"e422","DOI":"10.1016\/S1473-3099(19)30567-5","article-title":"Current gaps in sepsis immunology: new opportunities for translational research","volume":"19","author":"Rubio","year":"2019","journal-title":"Lancet Infect. Dis."},{"issue":"14","key":"10.1016\/j.ajem.2025.09.024_bb0195","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.3390\/cells13141172","article-title":"Evolving paradigms in Sepsis management: A narrative review","volume":"13","author":"Kim","year":"2024","journal-title":"Cells"},{"issue":"5","key":"10.1016\/j.ajem.2025.09.024_bb0200","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3390\/cells13050439","article-title":"Advances and challenges in Sepsis management: modern tools and future directions","volume":"13","author":"Santacroce","year":"2024","journal-title":"Cells"}],"container-title":["The American Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675725006357?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675725006357?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T21:42:07Z","timestamp":1770154927000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735675725006357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":40,"alternative-id":["S0735675725006357"],"URL":"https:\/\/doi.org\/10.1016\/j.ajem.2025.09.024","relation":{},"ISSN":["0735-6757"],"issn-type":[{"value":"0735-6757","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Peripheral Perfusion vs Standard Management in Sepsis\/Septic Shock: A Prospective Randomized ED Study","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajem.2025.09.024","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}