The intricate relationship between capillary refill time and systemic hemodynamics in septic shock

Simple item page
dc.article.number135
dc.catalogadorjca
dc.contributor.authorHernández Poblete, Glenn Wilson
dc.contributor.authorKattan Tala, Eduardo José
dc.contributor.authorOspina Tascón, Gustavo
dc.contributor.authorBravo Morales, Sebastián Ignacio
dc.contributor.authorOrozco, Nicolás
dc.contributor.authorGarcía Gallardo, Gustavo
dc.contributor.authorAmthauer Rojas, Macarena Paz
dc.contributor.authorLuo, Jing-Chao
dc.contributor.authorBakker, Jan
dc.date.accessioned2025-10-21T14:12:15Z
dc.date.available2025-10-21T14:12:15Z
dc.date.issued2025
dc.date.updated2025-10-08T14:34:44Z
dc.description.abstractThe emergence and validation of capillary refill time (CRT) as a resuscitation target together with its rapid kinetics of response to increases in systemic blood flow makes it the ideal variable to assess clinical reperfusion and the status of macro-to-microcirculatory coupling in septic shock. Moreover, previous studies have shown that resuscitation can be safely stopped after CRT normalization, thus decreasing the risk of over-resuscitation. From a physiological point of view, CRT is a complex variable integrating microvascular flow and reactivity. Additionally, it may be understood as a dynamic test that evaluates the preservation or disruption of normal responses of the microcirculation to maintain blood flow after transient ischemic challenges. The relationship between systemic hemodynamics and CRT is complex. Indeed, single time-point asssessments of CRT are not able to predict absolute cardiac output values and this is logical since they belong to different phsyiological categories. An abnormal CRT may be explained by insufficient macrohemodynamic resuscitation but also by several derangements at the microvascular level that may preclude CRT normalization, thus signaling a state of macro-to-microcirculatory uncoupling. CRT response to an acute fluid or mean arterial pressure challenge, may not only reveal the adequacy of systemic blood flow but also contribute to tailor interventions to personalize septic shock resuscitation. The lack of CRT response to these challenges discloses a more complex pathophysiological condition that is associated with higher mortality. Further research efforts should be focused on better understanding the factors associated with CRT non-response as a first step to develop a more phsyiologically-based resuscitation, that could eventually improve outcomes.
dc.fechaingreso.objetodigital2025-10-08
dc.format.extent10 páginas
dc.fuente.origenBiomed Central
dc.identifier.eissn2110‑5820
dc.identifier.urihttps://doi.org/10.1186/s13613-025-01563-8
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/106283
dc.information.autorucEscuela de Medicina; Hernández Poblete, Glenn Wilson; 0000-0002-3032-4087; 98874
dc.information.autorucEscuela de Medicina; Kattan Tala, Eduardo José; 0000-0002-1997-6893; 172152
dc.information.autorucEscuela de Medicina; Bravo Morales, Sebastián Ignacio; 0000-0003-0998-8433; 13431
dc.information.autorucEscuela de Enfermería; Amthauer Rojas, Macarena Paz; S/I; 163666
dc.language.isoen
dc.nota.accesocontenido completo
dc.revistaAnnals of Intensive Care
dc.rightsacceso abierto
dc.rights.licenseCreative Commons Attribution 4.0 International License
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectCapillary refill time
dc.subjectSeptic shock
dc.subjectResuscitation
dc.subjectFluid challenge
dc.subjectMean arterial pressure challenge
dc.subjectMacroto-microcirculatory coupling
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleThe intricate relationship between capillary refill time and systemic hemodynamics in septic shock
dc.typeartículo
dc.volumen15
sipa.codpersvinculados98874
sipa.codpersvinculados172152
sipa.codpersvinculados13431
sipa.codpersvinculados163666
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13613_2025_Article_1563.pdf
Size:
1.13 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.98 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Artículos de revistas