Hemodynamics, fluids & transfusion
Relationship between skin microvascular blood flow and capillary refill time in critically ill patients
Authors' conclusion
We have shown that index CRT and SBF were correlated, providing evidence that CRT is a reliable marker of microvascular blood flow.
Study context
- Population
- Adults admitted to intensive care unit (ICU) with circulatory failure and a measurable capillary refill time (CRT)54% admitted for sepsis
- Participants
- 50 adults
- Outcome
- Correlation between index SBF (laser doppler flowmetry) and CRT on the fingertip
- Follow-up
- T0 (within the first 48 h from admission) and T1 (4 to 6 h later)
Methodological detailssingle-centre, tertiary teaching hospital
- Single-centre
- Tertiary teaching hospital
Main finding
As reported in the abstract
Median CRT at baseline, seconds
2.0
1.1–3.9
Median skin blood flow (SBF) at baseline, PU
46
20–184
SBF vs CRT correlation (curvilinear), R2
0.89
p < 0.0001
Observational data: associations, not effects.
Further findings
SBF–CRT correlation by sepsis (subgroup) · baseline
- Septic, R2
- 0.94; p = 0.0013
- Non-septic, R2
- 0.87; p < 0.0001
SBF–CRT correlation by norepinephrine (subgroup) · baseline
- Norepinephrine, R2
- 0.97; p = 0.0035
- No norepinephrine, R2
- 0.92; p < 0.0001
Changes in SBF vs changes in CRT · Between T0 and T1
- Correlation, R2
- 0.34; p < 0.0001
SBF vs tissue perfusion and CO
- SBF related to arterial lactate level
- P = 0.02
- No correlation with CO
Change in SBF by survival · Between T0 and T1
- Only survivors significantly improved SBF
SBF prediction of day-28 mortality (AUROC)
- AUROC at T0
- 85% (95% CI 76-91)
- AUROC at T1
- 90% (95% CI 78-100)
Original publication
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