Device-measured capillary refill time identifies critically ill cases in the emergency department

Area of Science:

• Emergency Medicine
• Critical Care
• Physiology

Background:

• Capillary refill time (CRT) is a non-invasive measure of tissue perfusion.
• Its utility in the emergency department (ED), especially with quantitative devices, requires further investigation.

Purpose of the Study:

• To assess the association between device-measured CRT on ED arrival and clinical severity.
• To determine if CRT can aid in early identification of critically ill patients.

Main Methods:

• Prospective, single-center observational study of 119 adult patients arriving via ambulance.
• Quantitative CRT device used for measurements; average of three readings analyzed.
• Critical illness defined by APACHE II score ≥ 25.

Main Results:

• CRT was significantly prolonged in patients with high APACHE II scores (2.56s vs. 1.67s, p=0.0012).
• Device-measured CRT demonstrated a higher area under the ROC curve than lactate (0.702 vs. 0.669).
• CRT showed a positive correlation with lactate and a trend with SOFA scores.

Conclusions:

• Device-measured CRT is associated with clinical severity in the ED.
• CRT may serve as an early marker for identifying critically ill patients.
• Quantitative CRT assessment warrants further clinical utility studies in emergency settings.