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Related Experiment Videos

Defining normal capillary refill: variation with age, sex, and temperature.

D L Schriger1, L Baraff

  • 1Emergency Medicine Center, UCLA Center for the Health Sciences 90024-1744.

Annals of Emergency Medicine
|September 1, 1988
PubMed
Summary

Capillary refill time, used to assess shock, varies significantly with age and temperature. The standard two-second limit is unreliable, leading to high false-positive rates in diverse populations.

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Area of Science:

  • Physiology
  • Medical Diagnostics

Background:

  • Capillary refill time (CRT) is a clinical indicator for assessing perfusion status, particularly in critically ill patients.
  • A widely recommended upper limit of normal for CRT is two seconds, though supporting evidence is lacking.

Purpose of the Study:

  • To evaluate the validity of the two-second upper limit for CRT.
  • To investigate the influence of age and temperature on CRT.

Main Methods:

  • CRT was measured in 100 children, 104 adults, and 100 elderly volunteers.
  • CRT was also assessed in 20 adults before and after cold water immersion (14°C).

Main Results:

  • Median CRT varied significantly by age and sex, with younger individuals and males exhibiting shorter times.

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  • Cold exposure markedly increased CRT (median 1.3s pre-immersion vs. 2.9s post-immersion, P < .01).
  • Applying a two-second limit yielded high false-positive rates: 4.0% (pediatric/adult males), 13.7% (adult females), and 29.0% (elderly).

    • Conclusions:

    • Capillary refill time is demonstrably dependent on both age and body temperature.
    • Revised upper limits for normal CRT are proposed: 2.9 seconds for adult women and 4.5 seconds for the elderly.
    • The temperature dependency questions the reliability of CRT in prehospital settings.