Exploring the relationship between capillary refill time, skin blood flow and microcirculatory reactivity during early resuscitation of patients with septic shock: a pilot study

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dc.contributor.authorContreras, Roberto
dc.contributor.authorHernandez, Glenn
dc.contributor.authorDaniel Valenzuela, Emilio
dc.contributor.authorGonzalez, Cecilia
dc.contributor.authorUlloa, Rodrigo
dc.contributor.authorSoto, Dagoberto
dc.contributor.authorCastro, Ricardo
dc.contributor.authorGuzman, Camila
dc.contributor.authorOviedo, Vanessa
dc.contributor.authorAlegria, Leyla
dc.contributor.authorVidal, Diego
dc.contributor.authorMorales, Sebastian
dc.contributor.authorAdolfo Ospina-Tascon, Gustavo
dc.contributor.authorBakker, Jan
dc.contributor.authorKattan, Eduardo
dc.date.accessioned2025-01-20T20:19:57Z
dc.date.available2025-01-20T20:19:57Z
dc.date.issued2023
dc.description.abstractCapillary refill time (CRT), a costless and widely available tool, has emerged as a promising target to guide septic shock resuscitation. However, it has yet to gain universal acceptance due to its potential inter-observer variability. Standardization of CRT assessment may minimize this problem, but few studies have compared this approach with techniques that directly assess skin blood flow (SBF). Our objective was to determine if an abnormal CRT is associated with impaired SBF and microvascular reactivity in early septic shock patients. Twelve septic shock patients were subjected to multimodal perfusion and hemodynamic monitoring for 24 h. Three time-points (0, 1, and 24 h) were registered for each patient. SBF was measured by laser doppler. We performed a baseline SBF measurement and two microvascular reactivity tests: one with a thermal challenge at 44 & DEG;C and other with a vascular occlusion test. Ten healthy volunteers were evaluated to obtain reference values. The patients (median age 70 years) exhibited a 28-day mortality of 50%. Baseline CRT was 3.3 [2.7-7.3] seconds. In pooled data analysis, abnormal CRT presented a significantly lower SBF when compared to normal CRT [44 (13.3-80.3) vs 193.2 (99.4-285) APU, p = 0.0001]. CRT was strongly associated with SBF (R-2 0.76, p < 0.0001). An abnormal CRT also was associated with impaired thermal challenge and vascular occlusion tests. Abnormal CRT values observed during early septic shock resuscitation are associated with impaired skin blood flow, and abnormal skin microvascular reactivity. Future studies should confirm these results.
dc.fuente.origenWOS
dc.identifier.doi10.1007/s10877-022-00946-7
dc.identifier.eissn1573-2614
dc.identifier.issn1387-1307
dc.identifier.urihttps://doi.org/10.1007/s10877-022-00946-7
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92553
dc.identifier.wosidWOS:000897377000001
dc.issue.numero3
dc.language.isoen
dc.pagina.final845
dc.pagina.inicio839
dc.revistaJournal of clinical monitoring and computing
dc.rightsacceso restringido
dc.subjectSepsis
dc.subjectSeptic shock
dc.subjectCapillary refill time
dc.subjectLactate
dc.subjectHemodynamics
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleExploring the relationship between capillary refill time, skin blood flow and microcirculatory reactivity during early resuscitation of patients with septic shock: a pilot study
dc.typeartículo
dc.volumen37
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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