Relationship between skin microvascular blood flow and capillary refill time in critically ill patients

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dc.article.number57
dc.catalogadorpva
dc.contributor.authorMorin, Alexandra
dc.contributor.authorMissri, Louai
dc.contributor.authorUrbina, Tomas
dc.contributor.authorBonny, Vincent
dc.contributor.authorGasperment, Maxime
dc.contributor.authorBernier, Juliette
dc.contributor.authorBaudel, Jean-Luc
dc.contributor.authorKattan Tala, Eduardo José
dc.contributor.authorMaury, Eric
dc.contributor.authorJoffre, Jérémie
dc.contributor.authorAit-Oufella, Hafid
dc.date.accessioned2025-03-21T16:26:05Z
dc.date.available2025-03-21T16:26:05Z
dc.date.issued2025
dc.date.updated2025-02-09T01:03:06Z
dc.description.abstractBackground Capillary refill time (CRT) and skin blood flow (SBF) have been reported to be strong predictors of mortality in critically ill patients. However, the relationship between both parameters remains unclear. Methods We conducted a prospective observational study in a tertiary teaching hospital. All patients older than 18 years admitted in the intensive care unit (ICU) with circulatory failure and a measurable CRT were included. We assessed index SBF by laser doppler flowmetry and CRT on the fingertip, at T0 (Within the first 48 h from admission) and T1 (4 to 6 h later). Correlation was computed using Spearman or Pearson’s formula. Results During a 2-month period, 50 patients were included, 54% were admitted for sepsis. At baseline median CRT was 2.0 [1.1–3.9] seconds and median SBF was 46 [20–184] PU. At baseline SBF strongly correlated with CRT (R2 = 0.89; p < 0.0001, curvilinear relationship), this correlation was maintained whether patients were septic or not (R2 = 0.94; p = 0.0013; R2 = 0.87; p < 0.0001, respectively), and whether they received norepinephrine or not (R2 = 0.97; p = 0.0035; R2 = 0.92; p < 0.0001, respectively). Between T0 and T1, changes in SBF also significantly correlated with changes in CRT (R2 = 0.34; p < 0.0001). SBF was related to tissue perfusion parameters such as arterial lactate level (p = 0.02), whilst no correlation was found with cardiac output. In addition, only survivors significantly improved their SBF between T0 and T1. SBF was a powerful predictor of day-28 mortality as the AUROC at T0 was 85% [95% IC [76–91]] and at T1 90% [95% IC [78–100]]. Conclusion We have shown that index CRT and SBF were correlated, providing evidence that CRT is a reliable marker of microvascular blood flow. Trial registration Comité de protection des personnes Ouest II N° 2023-A02046-39.
dc.fechaingreso.objetodigital2025-02-09
dc.format.extent8 páginas
dc.fuente.origenBiomed Central
dc.identifier.citationCritical Care. 2025 Feb 04;29(1):57
dc.identifier.doi10.1186/s13054-025-05285-y
dc.identifier.issn1364-8535
dc.identifier.urihttps://doi.org/10.1186/s13054-025-05285-y
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/102926
dc.information.autorucEscuela de Medicina; Kattan Tala, Eduardo José; 0000-0002-1997-6893; 172152
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherSpringer Nature
dc.revistaCritical Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/.
dc.subjectBlood flow
dc.subjectCapillary refill time
dc.subjectTissue perfusion
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRelationship between skin microvascular blood flow and capillary refill time in critically ill patients
dc.typeartículo
dc.volumen29
sipa.codpersvinculados172152
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