OBJECTIVES: Capillary refill time is a noninvasive method to assess tissue perfusion to determine shock status. Capillary refill time is defined as the time required to regain skin color after blanching pressure is applied. Although common methods to measure capillary refill time depend on clinicians' visual assessment, a new approach using a pulse oximeter waveform analysis exists, referred to as full finger reperfusion time. We aim to evaluate reproducibility and validity of the novel full finger reperfusion time measurement using clinicians' visual capillary refill time assessment as a reference standard. DESIGN: Prospective observational study. SETTING: PICUs and operating suites at a large academic children's hospital. PATIENTS: Ninety-nine children 1-12 years old with various skin color tones. INTERVENTIONS: Each child had 10 measurements, including five full finger reperfusion time and five clinician capillary refill time, alternating second and third digits. MEASUREMENTS AND MAIN RESULTS: Eighteen children had prolonged capillary refill time (> 2 s) and four children with capillary refill time greater than 3 seconds. Four-hundred eighty-five data pairs were analyzed. Intraclass correlation coefficient of full finger reperfusion time within each patient was 0.76 (95% CI, 0.68-0.83), demonstrating good reproducibility. Correlation coefficient between full finger reperfusion time and clinician capillary refill time was moderate: r = 0.37 (p < 0.0001; 95% CI, 0.29-0.44) for the pairs and r = 0.52 (p < 0.0001; 95% CI, 0.36-0.65) for patient average. Bland-Altman plot showed a consistent difference between full finger reperfusion time and clinician capillary refill time (full finger reperfusion time 1.14 s longer). Weak association was found between force and full finger reperfusion time (β = -0.033 ± 0.016; 95% CI, -0.065 to -0.0016; p = 0.04), finger thickness (β = -0.20 ± 0.089; 95% CI, -0.37 to -0.19; p = 0.03), except for color tone (p = 0.31). Finger temperature was associated with full finger reperfusion time (β = -0.18 ± 0.041; 95% CI, -0.26 to -0.0999; p < 0.0001). CONCLUSIONS: Full finger reperfusion time demonstrated good reproducibility. Full finger reperfusion time showed moderate correlation with clinician capillary refill time. Full finger reperfusion time was 1.14 seconds longer than capillary refill time. Future studies should focus on the clinical value of full finger reperfusion time as a monitoring device for hemodynamics in critically ill children.
OBJECTIVES: Capillary refill time is a noninvasive method to assess tissue perfusion to determine shock status. Capillary refill time is defined as the time required to regain skin color after blanching pressure is applied. Although common methods to measure capillary refill time depend on clinicians' visual assessment, a new approach using a pulse oximeter waveform analysis exists, referred to as full finger reperfusion time. We aim to evaluate reproducibility and validity of the novel full finger reperfusion time measurement using clinicians' visual capillary refill time assessment as a reference standard. DESIGN: Prospective observational study. SETTING: PICUs and operating suites at a large academic children's hospital. PATIENTS: Ninety-nine children 1-12 years old with various skin color tones. INTERVENTIONS: Each child had 10 measurements, including five full finger reperfusion time and five clinician capillary refill time, alternating second and third digits. MEASUREMENTS AND MAIN RESULTS: Eighteen children had prolonged capillary refill time (> 2 s) and four children with capillary refill time greater than 3 seconds. Four-hundred eighty-five data pairs were analyzed. Intraclass correlation coefficient of full finger reperfusion time within each patient was 0.76 (95% CI, 0.68-0.83), demonstrating good reproducibility. Correlation coefficient between full finger reperfusion time and clinician capillary refill time was moderate: r = 0.37 (p < 0.0001; 95% CI, 0.29-0.44) for the pairs and r = 0.52 (p < 0.0001; 95% CI, 0.36-0.65) for patient average. Bland-Altman plot showed a consistent difference between full finger reperfusion time and clinician capillary refill time (full finger reperfusion time 1.14 s longer). Weak association was found between force and full finger reperfusion time (β = -0.033 ± 0.016; 95% CI, -0.065 to -0.0016; p = 0.04), finger thickness (β = -0.20 ± 0.089; 95% CI, -0.37 to -0.19; p = 0.03), except for color tone (p = 0.31). Finger temperature was associated with full finger reperfusion time (β = -0.18 ± 0.041; 95% CI, -0.26 to -0.0999; p < 0.0001). CONCLUSIONS: Full finger reperfusion time demonstrated good reproducibility. Full finger reperfusion time showed moderate correlation with clinician capillary refill time. Full finger reperfusion time was 1.14 seconds longer than capillary refill time. Future studies should focus on the clinical value of full finger reperfusion time as a monitoring device for hemodynamics in critically ill children.
Authors: Susannah Fleming; Peter Gill; Caroline Jones; James A Taylor; Ann Van den Bruel; Carl Heneghan; Matthew Thompson Journal: Arch Dis Child Date: 2014-09-26 Impact factor: 3.791
Authors: Glenn Hernández; Gustavo A Ospina-Tascón; Lucas Petri Damiani; Elisa Estenssoro; Arnaldo Dubin; Javier Hurtado; Gilberto Friedman; Ricardo Castro; Leyla Alegría; Jean-Louis Teboul; Maurizio Cecconi; Giorgio Ferri; Manuel Jibaja; Ronald Pairumani; Paula Fernández; Diego Barahona; Vladimir Granda-Luna; Alexandre Biasi Cavalcanti; Jan Bakker; Glenn Hernández; Gustavo Ospina-Tascón; Lucas Petri Damiani; Elisa Estenssoro; Arnaldo Dubin; Javier Hurtado; Gilberto Friedman; Ricardo Castro; Leyla Alegría; Jean-Louis Teboul; Maurizio Cecconi; Maurizio Cecconi; Giorgio Ferri; Manuel Jibaja; Ronald Pairumani; Paula Fernández; Diego Barahona; Alexandre Biasi Cavalcanti; Jan Bakker; Glenn Hernández; Leyla Alegría; Giorgio Ferri; Nicolás Rodriguez; Patricia Holger; Natalia Soto; Mario Pozo; Jan Bakker; Deborah Cook; Jean-Louis Vincent; Andrew Rhodes; Bryan P Kavanagh; Phil Dellinger; Wim Rietdijk; David Carpio; Nicolás Pavéz; Elizabeth Henriquez; Sebastian Bravo; Emilio Daniel Valenzuela; Magdalena Vera; Jorge Dreyse; Vanessa Oviedo; Maria Alicia Cid; Macarena Larroulet; Edward Petruska; Claudio Sarabia; David Gallardo; Juan Eduardo Sanchez; Hugo González; José Miguel Arancibia; Alex Muñoz; Germán Ramirez; Florencia Aravena; Andrés Aquevedo; Fabián Zambrano; Milan Bozinovic; Felipe Valle; Manuel Ramirez; Victor Rossel; Pilar Muñoz; Carolina Ceballos; Christian Esveile; Cristian Carmona; Eva Candia; Daniela Mendoza; Aída Sanchez; Daniela Ponce; Daniela Ponce; Jaime Lastra; Bárbara Nahuelpán; Fabrizio Fasce; Cecilia Luengo; Nicolas Medel; Cesar Cortés; Luz Campassi; Paolo Rubatto; Nahime Horna; Mariano Furche; Juan Carlos Pendino; Lisandro Bettini; Carlos Lovesio; María Cecilia González; Jésica Rodruguez; Héctor Canales; Francisco Caminos; Cayetano Galletti; Estefanía Minoldo; Maria Jose Aramburu; Daniela Olmos; Nicolás Nin; Jordán Tenzi; Carlos Quiroga; Pablo Lacuesta; Agustín Gaudín; Richard Pais; Ana Silvestre; Germán Olivera; Gloria Rieppi; Dolores Berrutti; Marcelo Ochoa; Paul Cobos; Fernando Vintimilla; Vanessa Ramirez; Milton Tobar; Fernanda García; Fabricio Picoita; Nelson Remache; Vladimir Granda; Fernando Paredes; Eduardo Barzallo; Paul Garcés; Fausto Guerrero; Santiago Salazar; German Torres; Cristian Tana; José Calahorrano; Freddy Solis; Pedro Torres; Luís Herrera; Antonio Ornes; Verónica Peréz; Glenda Delgado; Alexei López; Eliana Espinosa; José Moreira; Blanca Salcedo; Ivonne Villacres; Jhonny Suing; Marco Lopez; Luis Gomez; Guillermo Toctaquiza; Mario Cadena Zapata; Milton Alonso Orazabal; Ruben Pardo Espejo; Jorge Jimenez; Alexander Calderón; Gustavo Paredes; José Luis Barberán; Tatiana Moya; Horacio Atehortua; Rodolfo Sabogal; Guillermo Ortiz; Antonio Lara; Fabio Sanchez; Alvaro Hernán Portilla; Humberto Dávila; Jorge Antonio Mora; Luis Eduardo Calderón; Ingrid Alvarez; Elena Escobar; Alejandro Bejarano; Luis Alfonso Bustamante; José Luis Aldana Journal: JAMA Date: 2019-02-19 Impact factor: 56.272
Authors: Scott L Weiss; Mark J Peters; Waleed Alhazzani; Michael S D Agus; Heidi R Flori; David P Inwald; Simon Nadel; Luregn J Schlapbach; Robert C Tasker; Andrew C Argent; Joe Brierley; Joseph Carcillo; Enitan D Carrol; Christopher L Carroll; Ira M Cheifetz; Karen Choong; Jeffry J Cies; Andrea T Cruz; Daniele De Luca; Akash Deep; Saul N Faust; Claudio Flauzino De Oliveira; Mark W Hall; Paul Ishimine; Etienne Javouhey; Koen F M Joosten; Poonam Joshi; Oliver Karam; Martin C J Kneyber; Joris Lemson; Graeme MacLaren; Nilesh M Mehta; Morten Hylander Møller; Christopher J L Newth; Trung C Nguyen; Akira Nishisaki; Mark E Nunnally; Margaret M Parker; Raina M Paul; Adrienne G Randolph; Suchitra Ranjit; Lewis H Romer; Halden F Scott; Lyvonne N Tume; Judy T Verger; Eric A Williams; Joshua Wolf; Hector R Wong; Jerry J Zimmerman; Niranjan Kissoon; Pierre Tissieres Journal: Pediatr Crit Care Med Date: 2020-02 Impact factor: 3.624
Authors: Yong Y Han; Joseph A Carcillo; Michelle A Dragotta; Debra M Bills; R Scott Watson; Mark E Westerman; Richard A Orr Journal: Pediatrics Date: 2003-10 Impact factor: 7.124
Authors: Susannah Fleming; Peter Gill; Caroline Jones; James A Taylor; Ann Van den Bruel; Carl Heneghan; Nia Roberts; Matthew Thompson Journal: PLoS One Date: 2015-09-16 Impact factor: 3.240