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Capillary refill time in term neonates: bedside assessment.

D V Raichur1, A P Aralihond, A V Kasturi

  • 1Department of Pediatrics, Karnatak Institute of Medical Sciences, Hubli-580022, India. dr.devaraj@usa.net

Indian Journal of Pediatrics
|August 25, 2001
PubMed
Summary

Capillary refill time (CRT) in neonates is not yet a reliable indicator of peripheral circulation. Measurements varied significantly between observers and body sites, requiring further validation for clinical use.

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Area of Science:

  • Neonatal physiology
  • Clinical assessment techniques
  • Peripheral circulation evaluation

Background:

  • Capillary refill time (CRT) is a potential indicator of peripheral circulation.
  • Its reliability and standardization in neonates remain unestablished.
  • Further research is needed to validate CRT as a clinical sign in newborns.

Purpose of the Study:

  • To assess factors influencing CRT measurements in healthy term neonates.
  • Investigate the impact of body site, interobserver variability, sex, birth weight, age, and room temperature.
  • Determine the suitability of CRT as a specific clinical sign for neonatal peripheral circulation.

Main Methods:

  • Bedside measurement of CRT in 155 healthy term neonates by two observers.
  • Measurements were taken at four body sites: forehead, chest, palm, and heel.

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  • Statistical analysis examined interobserver variability and associations with demographic and environmental factors.

    • Main Results:

    • Significant interobserver variability was found for forehead, palm, and heel CRT measurements.
    • Chest CRT showed no significant mean difference between observers, with fair agreement (r=0.4).
    • CRT was not significantly associated with sex or birth weight; associations with age and temperature were clinically insignificant.

    Conclusions:

    • Capillary refill time (CRT) in neonates requires further validation before clinical application.
    • Interobserver variability and site-specific differences challenge its current utility.
    • Standardization and further studies are essential to establish CRT as a reliable neonatal circulatory assessment tool.