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Non-invasive ultrasound defines snuffbox artery RI and PI reference ranges in healthy volunteers versus ICU patients with septic shock or hypertension.

Non-invasive ultrasound defines snuffbox artery RI and PI reference ranges in healthy volunteers ver…
Photo by Judy Beth Morris / Unsplash
Key Takeaway
Note that non-invasive ultrasound defines snuffbox artery RI and PI reference ranges in healthy volunteers versus ICU patients.

This prospective observational cohort study evaluated hemodynamic parameters in a population of 91 healthy volunteers and 55 ICU patients. The setting was a 4,900-bed tertiary care hospital with a 215-bed closed ICU in China. Conditions of interest included septic shock and hypertension. The intervention or exposure was non-invasive ultrasound and clinical record review. The comparator group consisted of healthy volunteers versus ICU patients.

Main results showed that snuffbox artery RI in healthy volunteers ranged from 0.72 to 0.75. Snuffbox artery PI in healthy volunteers ranged from 1.93 to 2.03. Significant differences were found for RI between healthy volunteers and ICU patients, with all p < a specific threshold not reported. Significant differences were also found for end-diastolic flow velocity (EDV) between healthy volunteers and ICU patients, with all p < a specific threshold not reported.

Safety and tolerability data were not reported. Adverse events, serious adverse events, discontinuations, and tolerability were not specified in the input. Key limitations include that normal reference ranges of the snuffbox artery RI and pulsatility index (PI) remain undefined. Inconsistent RI data in healthy populations due to non-standardized measurements is another limitation. The study does not establish causality. Practice relevance is restrained by the observational design and the specific hospital setting.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundSystemic 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.ObjectiveThis 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.DesignThis was a single-center prospective observational cohort study.SettingThis study was conducted at a 4,900-bed tertiary care hospital with a 215-bed closed ICU in China.ParticipantsA 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.InterventionsNo interventional measures were implemented; all data were collected through a non-invasive ultrasound and clinical record review.Measurements and main resultsUltrasound 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 p 
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