Perspectives for capillary refill time in clinical practice for sepsis

Area of Science:

• Critical care medicine
• Physiology
• Medical diagnostics

Background:

• Capillary refill time (CRT) measures peripheral circulation.
• CRT aids in guiding fluid therapy for sepsis.
• Inconsistent performance and interpretation limit CRT's clinical use.

Purpose of the Study:

• Provide physicians with a concise overview of CRT.
• Explore evidence on CRT's reliability and value in sepsis management.

Main Methods:

• Narrative review of existing literature.

Main Results:

• Identified factors influencing CRT: age, sex, temperature, light, technique, experience, training, and measurement differences.
• Synthesized methods to reduce CRT variability.
• Recommended a standardized CRT assessment method based on reproducible measurements and high inter-rater agreement.
• Discussed normal CRT thresholds and applications in sepsis management phases.

Conclusions:

• CRT is valuable in critically ill patients, particularly in sepsis.
• Standardized methods and trained personnel are crucial for accurate CRT assessment.
• CRT reflects microcirculation, perfusion, organ dysfunction, and outcomes, making it attractive for sepsis management.
• Further research is needed to confirm CRT's value in sepsis management.