Evaluation of Automated Finger Compression for Capillary Refill Time Measurement in Pediatrics

Area of Science:

• Pediatric Emergency Medicine
• Cardiovascular Physiology
• Medical Device Technology

Background:

• Capillary refill time (CRT) is vital for identifying and monitoring pediatric shock.
• Manual CRT measurement can be inconsistent, impacting patient care.
• Automated systems aim to improve CRT measurement reliability.

Purpose of the Study:

• To determine the optimal compression pressure for an automated CRT monitoring device in children.
• To minimize inconsistency in CRT measurements using an automated compression device.

Main Methods:

• Clinician force data (12.9 N) from manual CRT measurements informed automated device settings.
• An automated device with a force sensor evaluated pressures from 300 to 500 mm Hg.
• Effectiveness was assessed by the elimination of pulsatile blood flow and CRT variance.

Main Results:

• Pressures of 400 and 500 mm Hg effectively eliminated pulsatile blood flow in automated CRT measurements.
• No significant difference in median CRT was observed between 400 mm Hg (1.8) and 500 mm Hg (1.87).
• Automated CRT demonstrated superior consistency at 500 mm Hg (variance 1.35) compared to 400 mm Hg (variance 2.99), with higher intraclass correlation (0.78 vs. 0.56).

Conclusions:

• Automated CRT measurement using 400 or 500 mm Hg is appropriate for pediatric shock assessment.
• 500 mm Hg provides superior consistency and reliability for automated CRT measurements.
• This technology can improve the accuracy of shock monitoring in children.