Ussel

Sepsis and its severe form, septic shock, are serious health concerns characterized by organ failure and acute circulatory problems like low blood volume, blood vessel dilation, and heart dysfunction. Researchers are evaluating whether measuring microcirculation parameters such as the peripheral perfusion index and skin marbling by nurses can improve early treatment decisions and patient outcomes. This study focuses on the early detection of tissue blood flow problems that may not be obvious through standard measurements and aims to assess if early vascular filling based on these measures can reduce deterioration and mortality. Participants will be monitored using classic hemodynamic parameters plus additional measurements of peripheral perfusion index and marbling score. If the peripheral perfusion index is 3 seconds or more or marbling is present at a score of 1 or higher, nurses will initiate a vascular filling test by administering 500 cc of fluid over 30 minutes after confirmation by a senior doctor. All patients will continue to receive standard care treatments. This intervention period is closely linked to emergency department admission. Throughout the study, patients will be followed for 7 days to track clinical outcomes including deterioration within 24 hours after inclusion, organ function changes, mortality, lung fluid overload, and care setting decisions such as discharge or intensive care admission. The study also compares nurse and physician assessments of microcirculation. This detailed monitoring includes timing of treatment bundles and safety checks to evaluate how early microcirculation measurement impacts sepsis management and patient prognosis.