Capillary refill time response to a fluid challenge or a vasopressor test: an observational, proof-of-concept study
Authors' conclusion
Our findings support that fluid boluses may improve CRT or produce neutral effects in fluid-responsive septic shock patients with persistent hypoperfusion. Conversely, raising NE doses to target a higher MAP in previously hypertensive patients elicits a more heterogeneous response, improving CRT in the majority, but deteriorating skin perfusion in some patients, a fact that deserves further research.
Study context
- Population
- Septic shock patients with abnormal capillary refill time (CRT) after initial resuscitation
- Participants
- 34 patients
- Exposure
- Fluid challenge (FC) vs vasopressor test (VPT)
- FCn = 9
- VPTn = 25
- Outcome
- Direction and magnitude of CRT response
- Follow-up
- End of interventions
Main finding
As reported in the abstract
CRT, baseline to end of intervention
CRT change (median [IQR])
from 5 [3.5-7.6] to 4 [2.4-5.1] sec
P = 0.008
FC
CRT change (median [IQR])
from 4.0 [3.3-5.6] to 3 [2.6 −5] sec
P = 0.03
VPT
Observational data: associations, not effects.
Further findings
| Outcome | FC | VPT |
|---|---|---|
| CRT-response | 7/9 events | 14/25 events |
Safety
- CRT deterioration after VPT
- 4 · events
Original publication
Capillary refill time response to a fluid challenge or a vasopressor test: an observational, proof-of-concept study. Ann Intensive Care. Published 1 April 2024. doi:10.
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