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Related Experiment Videos

Capillary refill: prognostic value in Kenyan children.

A Pamba1, K Maitland

  • 1Centre for Geographic Medicine Research, Coast, KEMRI/Wellcome Trust Unit, PO Box 230, Kilifi, Kenya.

Archives of Disease in Childhood
|September 24, 2004
PubMed
Summary

Delayed capillary refill time (dCRT) can indicate poor prognosis in Kenyan children, especially with severe illness. However, dCRT alone is insufficient for diagnosis in non-severe cases, requiring additional indicators for timely intervention.

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Area of Science:

  • Pediatric critical care
  • Infectious disease epidemiology
  • Clinical diagnostics

Background:

  • Capillary refill time (CRT) is a simple bedside test used to assess circulatory status.
  • Its prognostic value in critically ill children in resource-limited settings requires further investigation.

Purpose of the Study:

  • To evaluate the utility of delayed capillary refill time (dCRT) as a prognostic indicator in hospitalized Kenyan children.
  • To determine if dCRT can identify high-risk pediatric populations for mortality.

Main Methods:

  • A cohort of 4160 children admitted to Kilifi District Hospital with various severe illnesses were studied.
  • Data on delayed capillary refill time (dCRT) and other clinical indicators were collected and analyzed.

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Main Results:

  • Delayed capillary refill time (dCRT) was present in 8% of children and was significantly more common in fatal cases (23%) than survivors (7.5%).
  • dCRT showed prognostic value in identifying high-risk groups for mortality in children with malaria, gastroenteritis, or malnutrition.
  • In children with impaired consciousness or deep breathing, a dCRT >2 seconds identified significant proportions of those with hypotension or requiring volume resuscitation.

Conclusions:

  • While CRT is a valuable bedside tool in resource-poor settings, dCRT should not be relied upon as the sole indicator of severity.
  • In non-severe cases, additional signs like hypoxia, elevated creatinine, or a high white cell count should prompt fluid resuscitation.