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Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb
Published on: December 2, 2017
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Association between venous blood lactate levels and differences in quantitative capillary refill time
Yasufumi Oi1,2, Kosuke Sato1,2, Ayako Nogaki1,2
1Emergency Care Department Yokohama City University Hospital Yokohama Japan.
Acute Medicine & Surgery
|October 20, 2018
Summary
A new index, ΔAb, measured by quantitative capillary refill time, is a feasible, non-invasive tool for assessing high lactate levels in emergency settings. This method offers a rapid evaluation of circulatory status in critical care.
Area of Science:
- Emergency Medicine
- Critical Care
- Physiology
Background:
- Capillary refill time (CRT) is a standard clinical assessment for circulatory status in emergency settings.
- Previous research indicated a link between quantitative CRT and lactate levels in ICUs, but not in emergency departments.
- Limitations of traditional CRT necessitate the development of more precise quantitative measures.
Purpose of the Study:
- To identify a quantitative index of circulatory status, termed ΔAb, measurable with quantitative CRT.
- To evaluate the association between this novel index (ΔAb) and lactate levels in emergency department patients.
- To establish ΔAb as a clinically applicable tool for assessing circulatory status.
Main Methods:
- Prospective, single-center observational study conducted from November 2015 to July 2016.
- Inclusion of 139 patients with endogenous diseases.
- Measurement of quantitative capillary refill time, ΔAb (using a pulse oximeter), and lactate levels.
Main Results:
- ΔAb demonstrated an independent and significant association with high lactate levels.
- The odds ratio for high lactate levels associated with ΔAb was 0.16 (95% CI: 0.05-0.45).
Conclusions:
- ΔAb, derived from quantitative CRT, serves as a surrogate index for lactate levels, addressing CRT's limitations.
- ΔAb is a feasible, non-invasive, and rapid method for assessing patients with high lactate levels in emergency care.
- Further multicenter, longitudinal studies are recommended to validate these findings.
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