Effect on capillary refill time of volume expansion and increase of the norepinephrine dose in patients with septic shock
Authors' conclusion
In septic shock patients with prolonged CRT, CRT very rarely improves with treatment when volume expansion increases cardiac output < 15% and increasing norepinephrine increases MAP < 15%. When the effects of fluid infusion on cardiac output and of norepinephrine on MAP are significant, the response of CRT is variable, as it decreases in some patients and remains stable in others which exhibit a dissociation between changes in macrohemodynamic variables and in CRT.
Study context
- Population
- Patients with septic shock
- Participants
- 69 patients
- Exposure
- Volume expansion vs Norepinephrine
- Volume expansionn = 33
- Norepinephrinen = 36
- Outcome
- Change in capillary refill time (CRT; video method, standardized fingertip pressure; change significant if >23%)
Main finding
As reported in the abstract
Fluid responders with baseline capillary refill time (CRT) ≥ 3 s (n = 13): CRT decreased in 8, unchanged in others
8 (dissociation CI vs CRT)
Observational data: associations, not effects.
Further findings
Inclusion > 24 h after starting norepinephrine, fluid responders with vs without CI–CRT dissociation
- With dissociation vs others
- 60% vs. 0%
Original publication
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